Active NPI
Laurie S. Conrad, P.T.
- Physical Therapist
- Duncansville, PA
National Provider Identifier
1124124490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT009154E
- Practice address
- 1041 3Rd Ave
Duncansville, PA 16635-1351 - Phone
- (814) 696-3873
- Fax
- (814) 696-3877
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT009154E | PA | Primary |
Addresses
Primary practice location
1041 3Rd Ave
Duncansville, PA 16635-1351
Mailing address
957 Saint Joseph St
Loretto, PA 15940-7003
Phone (814) 886-4012
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7735639 | Other | PA | AETNA NON-HMO |
| 259359 | Other | PA | HEALTH AMER/HEALTH ASSUR. |
| CO1696441 | Other | PA | HIGHMARK BLUE SHIELD |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT009154E | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124124490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "957 SAINT JOSEPH ST",
"city": "LORETTO",
"state": "PA",
"postal_code": "159407003",
"telephone_number": "814-886-4012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1041 3RD AVE",
"city": "DUNCANSVILLE",
"state": "PA",
"postal_code": "166351351",
"telephone_number": "814-696-3873",
"fax_number": "814-696-3877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONRAD",
"first_name": "LAURIE",
"middle_name": "S.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT009154E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NON-HMO",
"identifier": "7735639",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMER/HEALTH ASSUR.",
"identifier": "259359",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "CO1696441",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Duncansville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.