NPIMap

Individual provider Active NPI

Ryan Scott Conrad, M.D.

  • Neurology Physician
  • Mooresville, NC
National Provider Identifier
1346289402
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2005-01316 Issued in NC
Practice address
124 Professional Park Dr
Suite C
Mooresville, NC 28117-5609
Phone
(704) 662-3077
Fax
(704) 662-3458
NPI assigned
Jun 5, 2006
Last updated
Feb 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 009000335 NC
Neurology Physician 2084N0400X 2005-01316 NC Primary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 2015-01316 NC

Addresses

Primary practice location

124 Professional Park Dr
Suite C
Mooresville, NC 28117-5609

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 662-3077

Other identifiers 1

IdentifierTypeStateIssuer
5901715MedicaidNC

Other names 1

  • Dr. Ryan Scott Conrad Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804000432 NC Practitioner - NeurologyPractitioner - PsychiatryPractitioner - Sleep Medicine 3971578865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Psychiatry, Sleep Medicine
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

124 Professional Park Dr a
Mooresville, NC 28117-5610
Phone (704) 662-3077

3367 N NC 16 Business Hwy
Denver, NC 28037-8265
Phone (419) 221-6717

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
009000335NCMDSpecialist
2005-01316NCMDNeurology Physician
2015-01316NCMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, PA CurrentSince Nov 4, 2013 Accepting new patients
Piedmont Healthcare, P.a. Neurology CurrentSince Nov 4, 2013 Accepting new patients
United Sleep Medicine Associates PA Neurology Past Accepting new patients
The Neurological Institute PA Neurology PastSince Mar 23, 1996 Accepting new patients

Locations

124 Professional Park Dr
Ste A
Mooresville, NC 28117
Phone (704) 622-3077

124 Professional Park Dr
Ste C
Mooresville, NC 28117
Phone (704) 658-1095

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

Interoperability endpoints

  • Direct secure messaging: ryanconrad@phc.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1346289402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-662-3077",
            "fax_number": "704-662-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 PROFESSIONAL PARK DR",
            "address_2": "SUITE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175609",
            "telephone_number": "704-662-3077",
            "fax_number": "704-662-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "RYAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "009000335",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2005-01316",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NC",
            "license": "2015-01316",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901715",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYAN",
            "last_name": "CONRAD",
            "middle_name": "SCOTT",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.