Active NPI
Conrad James Blake, PHARMD
- Pharmacotherapy Pharmacist
- Reno, NV
National Provider Identifier
1497741144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- NV16076
- Practice address
- 3515 Airway Dr
Suite 210
Reno, NV 89511-1849 - Phone
- (775) 851-7788
- Fax
- (775) 851-7788
- NPI assigned
- Sep 27, 2005
- Last updated
- Aug 2, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | NV16076 | NV | Primary |
Addresses
Primary practice location
3515 Airway Dr
Suite 210
Reno, NV 89511-1849
Mailing address
2801 Grosmont Dr
Sparks, NV 89436-7047
Phone (775) 851-7788
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NV16076 | NV | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pax RX LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186012800000",
"number": "1497741144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 GROSMONT DR",
"city": "SPARKS",
"state": "NV",
"postal_code": "894367047",
"telephone_number": "775-851-7788",
"fax_number": "775-851-7787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3515 AIRWAY DR",
"address_2": "SUITE 210",
"city": "RENO",
"state": "NV",
"postal_code": "895111849",
"telephone_number": "775-851-7788",
"fax_number": "775-851-7788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "CONRAD",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2007-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NV",
"license": "NV16076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.