Individual provider Active NPI

Laurie S. Conrad, P.T.

  • Physical Therapist
  • Duncansville, PA
National Provider Identifier
1124124490
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009154E Issued in PA
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
7735639OtherPAAETNA NON-HMO
259359OtherPAHEALTH AMER/HEALTH ASSUR.
CO1696441OtherPAHIGHMARK 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

LicenseStateTypeSpecialty
PT009154EPAMDPhysical 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.

Verify at the official NPI Registry.