Megan Michelle Conrad, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TE010633 Issued in PA

Practice address

4702 E Main St
Belleville, PA 17004-9251

Phone

(717) 935-2105

Fax

(717) 935-5109

NPI assigned

Sep 15, 2015

Last updated

Sep 15, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Megan Michelle Gardner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1336518752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 870",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166520870",
            "telephone_number": "814-506-8212",
            "fax_number": "814-506-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 E MAIN ST",
            "city": "BELLEVILLE",
            "state": "PA",
            "postal_code": "170049251",
            "telephone_number": "717-935-2105",
            "fax_number": "717-935-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "MEGAN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE010633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "GARDNER",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapy Assistant in Belleville, PA
• Providers in Belleville, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.

Verify at the official NPI Registry.