Individual provider Active NPI

Bradley Lawrence Conder, PT, DPT, OCS

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1679516637
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004698 Issued in KY
Practice address
11700 Commonwealth Dr Ste 601
Louisville, KY 40299-6303
Phone
(502) 509-3136
Fax
(502) 509-3136
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 004698 KY Primary

Addresses

Primary practice location

11700 Commonwealth Dr Ste 601
Louisville, KY 40299-6303

Mailing address

716 Malone PL
Louisville, KY 40245-4132
Phone (502) 509-3136

Other practice location 1

1860 Mellwood Ave Ste 267
Louisville, KY 40206-1033
Phone (502) 509-3136

Other identifiers 1

IdentifierTypeStateIssuer
004698OtherKYKY STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080606000165 KY Practitioner - Physical Therapist in Private Practice 0840360582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Kentucky College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Focus Physical Therapy LLCGroup PAC ID 6608305354, 3 clinicians

Practice addresses (Care Compare)

1860 Mellwood Ave
Suite 267
Louisville, KY 40206-1033
Phone (502) 509-3136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004698KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Physical Therapy LLC Physical Therapist CurrentSince Nov 11, 2024 Accepting new patients

Locations

1860 Mellwood Ave
Ste 267
Louisville, KY 40206
Phone (502) 509-3136

11700 Commonwealth Dr
Ste 601
Louisville, KY 40299
Phone (502) 245-1136

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1679516637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 MALONE PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402454132",
            "telephone_number": "502-509-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 COMMONWEALTH DR STE 601",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402996303",
            "telephone_number": "502-509-3136",
            "fax_number": "502-509-3136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1860 Mellwood Ave Ste 267",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402061033",
            "country_code": "US",
            "telephone_number": "502-509-3136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONDER",
        "first_name": "BRADLEY",
        "middle_name": "LAWRENCE",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY STATE LICENSE",
            "identifier": "004698",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.