Active NPI
Jade Conrad
- Massage Therapist
- Elizabethtown, KY
National Provider Identifier
1265804983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- BMTMTH00214650
- Practice address
- 100 Tallyho Way
Elizabethtown, KY 42701-7829 - Phone
- (270) 748-1824
- NPI assigned
- Oct 21, 2015
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | BMTMTH00214650 | KY | Primary |
Addresses
Primary practice location
100 Tallyho Way
Elizabethtown, KY 42701-7829
Mailing address
100 Tallyho Way
Elizabethtown, KY 42701-7829
Phone (270) 748-1824
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 |
|---|---|---|---|
| BMTMTH00214650 | KY | MD | Massage Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445385600000",
"number": "1265804983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 TALLYHO WAY",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427017829",
"telephone_number": "270-748-1824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 TALLYHO WAY",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427017829",
"telephone_number": "270-748-1824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONRAD",
"first_name": "JADE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-21",
"last_updated": "2015-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "KY",
"license": "BMTMTH00214650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.