Active NPI
Douglas S Conard, MD
- Ophthalmology Physician
- Lafayette, IN
National Provider Identifier
1619045192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 01028562A
- Practice address
- 214 N Farabee Drive
Lafayette, IN 47905 - Phone
- (765) 447-2525
- Fax
- (765) 449-4206
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 01028562A | IN | Primary |
Addresses
Primary practice location
214 N Farabee Drive
Lafayette, IN 47905
Mailing address
214 N Farabee Drive
Lafayette, IN 47905
Phone (765) 447-2525
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000829604 | Medicaid | IN | |
| 0174970001 | Other | IN | DMERC |
| 000000220476 | Other | IN | ANTHEM |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01028562A | IN | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1619045192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 N FARABEE DRIVE",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "47905",
"telephone_number": "765-447-2525",
"fax_number": "765-449-4206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 N FARABEE DRIVE",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "47905",
"telephone_number": "765-447-2525",
"fax_number": "765-449-4206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONARD",
"first_name": "DOUGLAS",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "01028562A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000829604",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0174970001",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000220476",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
- Community and Family Resource Center - the Counseling Center
- Community Ventures in Living, LTD.
- Comprehensive Pain and Spine Specialists LLC
- Devin Elisabeth Comte, NP
- Barbara B Conard, MD
- Kelli Ann Conlon
- Madeline Grace Connors
- Chelsye Linne Conrad, RBT
- Jessica Conrad, RN
- Mario Rolando Contreras, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.