Individual provider Active NPI

Mary M. Farris-Conley, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1902100878
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN15653 Issued in TN
Practice address
877 Jefferson Ave
Memphis, TN 38103-2807
Phone
(901) 448-5893
Fax
(901) 448-5540
NPI assigned
Jan 6, 2011
Last updated
Feb 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN15653 TN Primary
Certified Registered Nurse Anesthetist 367500000X RN171807 TN

Addresses

Primary practice location

877 Jefferson Ave
Memphis, TN 38103-2807

Mailing address

877 Jefferson Ave
Attn: Provider Enrollment
Memphis, TN 38103-2807
Phone (901) 448-5893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110329000457 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658554621 Reassigns benefits to 2 organizations
I20250106000485 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658554621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Memphis Anesthesia Services PLCGroup PAC ID 1850386038, 26 clinicians
Willow Anesthesia Services LLCGroup PAC ID 9234279183, 52 clinicians

Practice addresses (Care Compare)

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

255 S Pauline St
Memphis, TN 38104-3221
Phone (901) 759-3100

7600 Airways Blvd
Suite F
Southaven, MS 38671-5138
Phone (901) 685-2200

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
APN15653TNMDCertified Registered Nurse Anesthetist
RN171807TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 11, 2025 Accepting new patients
East Memphis Anesthesia Services PLC CurrentSince Jun 27, 2023 Accepting new patients

Locations

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

6947 Crumpler Blvd
Olive Branch, MS 38654
Phone (662) 893-3300

499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979

7600 Airways Blvd
Ste F
Southaven, MS 38671
Phone (662) 349-5901

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

2100 Exeter Rd
Ste 101
Germantown, TN 38138
Phone (901) 405-8200

255 S Pauline St
Memphis, TN 38104
Phone (901) 261-2804

825 Ridge Lake Blvd
Memphis, TN 38120
Phone (901) 685-6150

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1902100878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-448-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-448-5893",
            "fax_number": "901-448-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS-CONLEY",
        "first_name": "MARY",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-06",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN15653",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN171807",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.