NPIMap

Individual provider Active NPI

Rachel A Conrad, CS FNP

  • Family Nurse Practitioner
  • Hurricane, WV
National Provider Identifier
1043234156
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
49148 Issued in WV
Practice address
147 Willow Tree Way
Hurricane, WV 25526-1085
Phone
(304) 397-3002
Fax
(304) 397-3007
NPI assigned
Jul 26, 2006
Last updated
Apr 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 49148 WV Primary

Addresses

Primary practice location

147 Willow Tree Way
Hurricane, WV 25526-1085

Mailing address

PO Box 4190
Barboursville, WV 25504-4190
Phone (304) 399-4405

Other identifiers 3

IdentifierTypeStateIssuer
2812497MedicaidOH
7100066180MedicaidKY
7104196000MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rachel.conrad@smmm.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070313000299 WV Practitioner - Nurse Practitioner 0244333268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2900 1St Ave
Suite 30
Huntington, WV 25702-1241
Phone (304) 399-7280

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Medical Management, LLC Family CurrentSince Jul 1, 2008 Accepting new patients
St. Mary's Medical Management, LLC CurrentSince Jul 1, 2008 Accepting new patients
St Marys Medical Center, Inc. Past Accepting new patients

Locations

143 Peyton St
Barboursville, WV 25504
Phone (304) 697-2035

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

2900 1st Ave
Ste 30
Huntington, WV 25702
Phone (304) 399-7280

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

147 Willow Tree Way
Hurricane, WV 25526
Phone (304) 397-3002

Organizations & group practices 3

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1043234156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4190",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255044190",
            "telephone_number": "304-399-4405",
            "fax_number": "304-399-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 WILLOW TREE WAY",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255261085",
            "telephone_number": "304-397-3002",
            "fax_number": "304-397-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "RACHEL",
        "middle_name": "A",
        "credential": "CS FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "49148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2812497",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100066180",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7104196000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rachel.conrad@smmm.cernerdirect.com",
            "affiliation": "N",
            "address_1": "147 Willow Tree Way",
            "city": "Hurricane",
            "state": "WV",
            "country_code": "US",
            "postal_code": "255261085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

Verify at the official NPI Registry.