NPIMap

Individual provider Active NPI

Debra Conrad

  • Intermediate Emergency Medical Technician
  • Rockville, MD
National Provider Identifier
1235154238
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intermediate Emergency Medical TechnicianTaxonomy code 146M00000X
License
D0062563 Issued in MD
Practice address
9901 Medical Center Dr
Rockville, MD 20850-3357
Phone
(301) 279-6550
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intermediate Emergency Medical Technician 146M00000X D0062563 MD Primary
Emergency Medicine Physician 207P00000X 0101035903 VA

Addresses

Primary practice location

9901 Medical Center Dr
Rockville, MD 20850-3357

Mailing address

7316 Normandy Dr
Richmond, VA 23229-6712
Phone (804) 282-2612

Other identifiers 3

IdentifierTypeStateIssuer
1235154238MedicaidVA
235836OtherVABLUE SHIELD
235837OtherVABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20041221000875 VA Practitioner - Pediatric Medicine 9436117587 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101035903VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Health Center Inc CurrentSince Jul 8, 2024 Accepting new patients
Blue Ridge Health Center Inc CurrentSince Jul 8, 2024 Accepting new patients
Blue Ridge Health Center Inc CurrentSince Jul 8, 2024 Accepting new patients
Childrens Hospital of the Kings Daughters Inc CurrentSince Oct 11, 2016 Accepting new patients
Mep Health, LLC Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients

Locations

624 Jones St
Appomattox, VA 24522
Phone (434) 263-4000

4038 Thomas Nelson Hwy
Arrington, VA 22922
Phone (434) 263-4000

817 Volvo Pkwy
Chesapeake, VA 23320
Phone (757) 668-4630

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1235154238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7316 NORMANDY DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232296712",
            "telephone_number": "804-282-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 MEDICAL CENTER DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503357",
            "telephone_number": "301-279-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "DEBRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "MD",
            "license": "D0062563",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101035903",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235154238",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "235836",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "235837",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.