Conrad Chiropractic, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC008957 Issued in PA

Legal business name

CONRAD CHIROPRACTIC, PC

Practice address

520 Church St
Lilly, PA 15938-1118

Phone

(814) 886-9414

Fax

(814) 886-9415

NPI assigned

Jan 6, 2010

Last updated

Jan 6, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tyler R Conrad, D.C.NPI 1548289812

Title

Owner

Phone

(814) 886-9414

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyler R Conrad, D.C.

  • Chiropractor
  • Lilly, PA
  • NPI 1548289812
  NPD (past) Authorized official

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1184954646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 CHURCH ST",
            "city": "LILLY",
            "state": "PA",
            "postal_code": "159381118",
            "telephone_number": "814-886-9414",
            "fax_number": "814-886-9415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 CHURCH ST",
            "city": "LILLY",
            "state": "PA",
            "postal_code": "159381118",
            "telephone_number": "814-886-9414",
            "fax_number": "814-886-9415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONRAD CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-886-9414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019523970001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alternative Community Resource Program, Inc.
• Alternative Community Resource Program, Inc.
• Amanda Rae Beck, BA
• Tyler R Conrad, D.C.
• Edward Joseph Dongell, DMD
• Jennifer Beth Kanuch, MS,RD,LDN
• Life Team LLC (West Slope Medical Transport)
• Lilly Area Ambulance Association

• Chiropractor in Lilly, PA
• Providers in Lilly, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.