Active NPI
Steven Alan Conley, PA-C
- Medical Physician Assistant
- Marietta, GA
National Provider Identifier
1922082015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 4242
- Practice address
- 1634 White Cir Ste 101
Marietta, GA 30066-5809 - Phone
- (678) 354-2943
- Fax
- (949) 703-7565
- NPI assigned
- Dec 1, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 4242 | GA | Primary |
Addresses
Primary practice location
1634 White Cir Ste 101
Marietta, GA 30066-5809
Mailing address
1634 White Cir Ste 101
Marietta, GA 30066-5809
Phone (678) 354-2943
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4242 | GA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729036800000",
"number": "1922082015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1634 WHITE CIR STE 101",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300665809",
"telephone_number": "678-354-2943",
"fax_number": "949-703-7565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1634 WHITE CIR STE 101",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300665809",
"telephone_number": "678-354-2943",
"fax_number": "949-703-7565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "STEVEN",
"middle_name": "ALAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-01",
"last_updated": "2024-10-16",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "GA",
"license": "4242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.