Individual provider Active NPI

Andrea D Conley, MSN, RN, AGCNS-BC

  • Acute Care Clinical Nurse Specialist
  • Fort Wayne, IN
National Provider Identifier
1811563265
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
28185235A Issued in IN
Practice address
11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone
(260) 266-2519
NPI assigned
May 27, 2021
Last updated
May 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 28185235A IN Primary

Addresses

Primary practice location

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Mailing address

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Other identifiers 1

IdentifierTypeStateIssuer
28185235AOtherINNURSING LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andrea.conley@parkview.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
28185235AINMDAcute Care Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1811563265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-266-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "ANDREA",
        "middle_name": "D",
        "credential": "MSN, RN, AGCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "IN",
            "license": "28185235A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "28185235A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrea.conley@parkview.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11109 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.