Individual provider Active NPI

Joseph P Conrad

  • Occupational Therapist
  • Bowling Green, OH
National Provider Identifier
1295063444
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT7290 Issued in OH
Practice address
850 W Poe Rd
Bowling Green, OH 43402-1219
Phone
(419) 866-5275
Fax
(419) 866-5663
NPI assigned
Nov 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT7290 OH Primary

Addresses

Primary practice location

850 W Poe Rd
Bowling Green, OH 43402-1219

Mailing address

1560 Henthorne Dr
Maumee, OH 43537-1371
Phone (419) 866-5275

Other identifiers 2

IdentifierTypeStateIssuer
2526654MedicaidOH
1609899061OtherOHCORP NPI

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
OT7290OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Therapy Alternatives, Inc Occupational Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1295063444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 HENTHORNE DR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371371",
            "telephone_number": "419-866-5275",
            "fax_number": "419-866-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W POE RD",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434021219",
            "telephone_number": "419-866-5275",
            "fax_number": "419-866-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-30",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT7290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2526654",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP NPI",
            "identifier": "1609899061",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; 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.