Individual provider Active NPI

Lawrence Conley, R.P.A

  • Physician Assistant
  • Liverpool, NY
National Provider Identifier
1972579902
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002256-1 Issued in NY
Practice address
5100 W Taft Rd
Suite #2G
Liverpool, NY 13088-3807
Phone
(315) 234-8977
Fax
(315) 234-8981
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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 002256-1 NY Primary

Addresses

Primary practice location

5100 W Taft Rd
Suite #2G
Liverpool, NY 13088-3807

Mailing address

5100 W Taft Rd
Suite 2G
Liverpool, NY 13088-3807
Phone (315) 312-0089

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002256-1NYMDAthletic Trainer
2256NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Familycare Medical Group, PC Physician Assistant PastSince Jul 30, 2018 Accepting new patients
Genesee Valley Group Health Association Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1972579902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 2G",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-312-0089",
            "fax_number": "315-234-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE #2G",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-234-8977",
            "fax_number": "315-234-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "R.P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002256-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.