Individual provider Active NPI

Terry Mann Conrad, PT

  • Physical Therapist
  • Starkville, MS
National Provider Identifier
1306272323
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2972 Issued in MS
Practice address
513 Academy Rd
Starkville, MS 39759-4021
Phone
(662) 268-8013
Fax
(662) 268-8095
NPI assigned
Sep 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2972 MS Primary

Addresses

Primary practice location

513 Academy Rd
Starkville, MS 39759-4021

Mailing address

513 Academy Rd
Starkville, MS 39759-4021
Phone (662) 268-8013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131216001472 MS Practitioner - Physical Therapist in Private Practice 9638306780 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT2972MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Dec 28, 2017 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Dec 28, 2017 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Jun 1, 2017 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist Past Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

199 N Brookmoore Dr
Columbus, MS 39705
Phone (662) 798-0108

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

513 Academy Rd
Starkville, MS 39759
Phone (662) 268-8013

Organizations & group practices 5

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1306272323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 ACADEMY RD",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397594021",
            "telephone_number": "662-268-8013",
            "fax_number": "662-268-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 ACADEMY RD",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397594021",
            "telephone_number": "662-268-8013",
            "fax_number": "662-268-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "TERRY",
        "middle_name": "MANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT2972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.