Individual provider Active NPI

Jodi A Conley, PA

  • Physician Assistant
  • Grayson, KY
National Provider Identifier
1891860599
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA355 Issued in KY
Practice address
100 Bellefonte Dr
Grayson, KY 41143-1820
Phone
(606) 474-0669
Fax
(606) 474-0376
NPI assigned
Nov 21, 2006
Last updated
May 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA355 KY Primary

Addresses

Primary practice location

100 Bellefonte Dr
Grayson, KY 41143-1820

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other identifiers 2

IdentifierTypeStateIssuer
1071595OtherWVBRICKSTREET/WV COMP
7100055310MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070521000172 KY Practitioner - Physician Assistant 4486751815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ashland Hospital CorporationGroup PAC ID 7719882521, 169 clinicians
Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

100 Bellefonte Dr
Grayson, KY 41143-1820
Phone (606) 474-0669

12100 Princeland Dr
Ashland, KY 41102-7885
Phone (606) 928-2963

2201 Lexington Ave
Ashland, KY 41101-2843
Phone (606) 408-4000

391 W Tom T Hall Blvd
Olive Hill, KY 41164-7688
Phone (606) 286-8039

710 N Carol Malone Boulevard
Grayson, KY 41143-1126
Phone (606) 474-0157

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.16 of 100Reported as group
Quality
77.42
Promoting interoperability
100
Improvement activities
40
Cost
77.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA355KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland Hospital Corporation CurrentSince May 26, 2020 Accepting new patients
Ashland Hospital Corporation CurrentSince May 26, 2020 Accepting new patients
Our Lady of Bellefonte Hospital, Inc. Past Accepting new patients
Ashland Emergency Medical Associates Past Accepting new patients
Ashland Hospital Corporation Physician Assistant Past Accepting new patients
Sanjiv Gupta, M.D., P.S.C. Past Accepting new patients

Locations

1000 Saint Christopher Dr
Ashland, KY 41101
Phone (606) 833-2273

12100 Princeland Spur
Ashland, KY 41102
Phone (606) 928-2963

2001 Winchester Ave
Ashland, KY 41101
Phone (606) 324-3444

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

100 Bellefonte Dr
Grayson, KY 41143
Phone (606) 474-0669

Interoperability endpoints

  • Direct secure messaging: jconley73345@direct.kdhealth.us

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1891860599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BELLEFONTE DR",
            "city": "GRAYSON",
            "state": "KY",
            "postal_code": "411431820",
            "telephone_number": "606-474-0669",
            "fax_number": "606-474-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "JODI",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKSTREET/WV COMP",
            "identifier": "1071595",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100055310",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayson, KY

Sources for this page

Verify at the official NPI Registry.