Individual provider Active NPI

Carrie Lynn Conley, P.A.-C

  • Physician Assistant
  • Fairbanks, AK
National Provider Identifier
1942500541
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PADA996 Issued in AK
Practice address
751 Old Richardson Hwy Ste 200
Fairbanks, AK 99701-7805
Phone
(907) 457-9420
Fax
(907) 457-1098
NPI assigned
Oct 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA60188305 WA
Physician Assistant 363A00000X PADA996 AK Primary

Addresses

Primary practice location

751 Old Richardson Hwy Ste 200
Fairbanks, AK 99701-7805

Mailing address

751 Old Richardson Hwy Ste 200
Fairbanks, AK 99701-7805
Phone (907) 457-9420

Other identifiers 1

IdentifierTypeStateIssuer
1597181MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20150729008813 AK Practitioner - Physician Assistant 3072700640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gold Star Longevity and Wellness LLCGroup PAC ID 3173863388, 8 clinicians

Practice addresses (Care Compare)

145 S Santa Claus LN
North Pole, AK 99705-7754
Phone (907) 488-4433

751 Old Richardson Hwy
Suite 200
Fairbanks, AK 99701-7805
Phone (907) 457-9420

Hospital & facility affiliations

  • Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Merit-based Incentive Payment System (MIPS)

Final score
92.86 of 100Reported as group
Quality
94.88
Promoting interoperability
100
Improvement activities
40
Cost
79.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60188305WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Valley Clinic LLC CurrentSince Jan 1, 2017 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Jan 1, 2017 Accepting new patients
Midnight Sun Family Medicine, PC Past Accepting new patients
Solstice Medicine & Wellness, LLC Past Accepting new patients

Locations

1919 Lathrop St
Ste 106
Fairbanks, AK 99701
Phone (907) 445-7123

1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806

1101 Noble St
Fairbanks, AK 99701
Phone (907) 458-2648

Interoperability endpoints

  • Direct secure messaging: carrie.conley.1@19690.direct.athenahealth.com

Organizations & group practices 5

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

Hospital & facility affiliations 1

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": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1942500541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 OLD RICHARDSON HWY STE 200",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017805",
            "telephone_number": "907-457-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 OLD RICHARDSON HWY STE 200",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017805",
            "telephone_number": "907-457-9420",
            "fax_number": "907-457-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "CARRIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-28",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60188305",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "PADA996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1597181",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.