Brock Conn, OTR/L
Individual provider Active NPI Occupational Therapist · Fairview, PA
NPI 1245053487 · NPPES record last updated Nov 6, 2024
Key facts
- NPI
- 1245053487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- Practice address
- 5510 Millfair Rd
Fairview, PA 16415-2228 - Phone
- (814) 250-1821
- Fax
- (814) 556-2092
- NPI assigned
- Nov 6, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cortlyn Therapy PC
Practice addresses (Care Compare)
1012 W Bayfront Pkwy
Erie, PA 16507-2324
Phone (814) 304-0820
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241209000831 | PA | Practitioner - Occupational Therapist in Private Practice | 9133655681 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OC020347 | PA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy at Your Place LLC | Occupational Therapist | Current |
Accepting new patients |
| Cortlyn Therapy, PC | Occupational Therapist | Current |
Accepting new patients |
Locations
28100 Torch Pkwy
Ste 600
Warrenville, IL 60555
Phone (630) 250-4576
7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817
1215 Hulton Rd
Oakmont, PA 15139
Phone (412) 659-2450
1361 E Boot Rd
West Chester, PA 19380
Phone (484) 653-1200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC020347 | PA | |
| Occupational Therapist | 225X00000X | Yes |
Addresses
Primary practice location
5510 Millfair Rd
Fairview, PA 16415-2228
Mailing address
5510 Millfair Rd
Fairview, PA 16415-2228
Phone (814) 250-1821
Other providers in Fairview, PA
- Jamie Lynn Cacchione
- Taylor Calnon
- Caring Chiropractic Services, PC
- Lianna Fay Carner
- Julie Cella
- Filippo Joseph Costanzo
- Cheyelle Couse
- Dameon L Covert
- Elizabeth Ashlee Davis
- Carolyn Sue Dixon
All providers in Fairview, PA · Occupational Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.