Active NPI
Teresa Ann Conrad, PT
- Physical Therapist
- Decatur, IN
National Provider Identifier
1386765808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05000823A
- Practice address
- 9202 NW Winchester Rd
Decatur, IN 46733-9756 - Phone
- (260) 417-4966
- Fax
- (775) 402-5791
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05000823A | IN | Primary |
Addresses
Primary practice location
9202 NW Winchester Rd
Decatur, IN 46733-9756
Mailing address
9202 NW Winchester Rd
Decatur, IN 46733-9756
Phone (260) 417-4966
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 |
|---|---|---|---|
| 05000823A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386765808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9202 NW WINCHESTER RD",
"city": "DECATUR",
"state": "IN",
"postal_code": "467339756",
"telephone_number": "260-417-4966",
"fax_number": "775-402-5791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9202 NW WINCHESTER RD",
"city": "DECATUR",
"state": "IN",
"postal_code": "467339756",
"telephone_number": "260-417-4966",
"fax_number": "775-402-5791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONRAD",
"first_name": "TERESA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05000823A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.