Active NPI
Theresa Lynn Conyers
- Contractor
- Dayton, OH
National Provider Identifier
1841807435
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Mar 20, 2023.
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- RR627109
- Practice address
- 3701 Wales Dr
Dayton, OH 45405-1848 - Phone
- (937) 620-4321
- NPI assigned
- Sep 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | RR627109 | OH | Primary |
Addresses
Primary practice location
3701 Wales Dr
Dayton, OH 45405-1848
Mailing address
3701 Wales Dr
Dayton, OH 45405-1848
Phone (937) 620-4321
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RR627109 | OH | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1841807435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 WALES DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454051848",
"telephone_number": "937-620-4321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 WALES DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454051848",
"telephone_number": "937-620-4321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONYERS",
"first_name": "THERESA",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-28",
"last_updated": "2020-09-28",
"certification_date": "2020-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "OH",
"license": "RR627109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.