Forest Reginald Conley, DO
Individual provider Active NPI Family Medicine Physician · Moberly, MO
NPI 1982603452 · NPPES record last updated May 8, 2023
Key facts
- NPI
- 1982603452
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- R7880 (MO)
- Practice address
- 1600 N Morley St
Moberly, MO 65270-3666 - Phone
- (660) 372-9595
- Fax
- (660) 372-9596
- NPI assigned
- Jul 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 20
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hannibal Regional Healthcare System Inc
Practice addresses (Care Compare)
1600 N Morley St
Moberly, MO 65270-3666
Phone (660) 372-9595
Hospital & facility affiliations
- Macon County Samaritan Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040129000554 | MO | Practitioner - General Practice | 9032012844 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R7880 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hannibal Regional Healthcare System, Inc | Current | Accepting new patients | |
| Hannibal Regional Healthcare System Inc | Current |
Accepting new patients | |
| Hannibal Regional Healthcare System, Inc | Family Medicine | Current |
Accepting new patients |
| Midwest Heart and Vein Center, LLC | Past | Accepting new patients | |
| Moberly Medical Clinics Inc | Past | Accepting new patients | |
| Moberly Medical Clinics Inc | Past | Accepting new patients |
Locations
6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400
1611 S Baltimore St
Kirksville, MO 63501
Phone (660) 372-9595
2100 Silva Ln
Ste A
Moberly, MO 65270
Phone (660) 263-7201
1600 N Morley St
Moberly, MO 65270
Phone (660) 263-1225
1600 N Morley St
Ste A120
Moberly, MO 65270
Phone (660) 263-1225
Interoperability endpoints
- https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
- forest.conley.p1@direct.cfmkv.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R7880 | MO | Yes |
Addresses
Primary practice location
1600 N Morley St
Moberly, MO 65270-3666
Mailing address
1600 N Morley St
Moberly, MO 65270-3666
Phone (660) 372-9595
Other practice location 1
2100 Silva Ln
Moberly, MO 65270-3677
Phone (660) 263-7201
Other providers in Moberly, MO
- Coates Street Comfort House
- Shelly Collins
- Compass Health, Inc.
- Comprehensive Care Services & Solutions, LLC
- Conley Clinic LLC
- Rebecca Jennette Cook
- Finess Copeland
- Bobbie Jo Cortez
- Anita Marie Cox
- Curators of the University of Missouri
All providers in Moberly, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.