Tara Anne Condon, MA, AT, ATC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

AT-008909 Issued in AZ

Practice address

801 Edith Rd
Louisville, KY 40206-2280

Phone

(845) 521-4398

NPI assigned

Jun 12, 2019

Last updated

Jun 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1689233785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9522 W HIGHLAND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 EDITH RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062280",
            "telephone_number": "845-521-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDON",
        "first_name": "TARA",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "MA, AT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "AZ",
            "license": "AT-008909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanna Conder, OTR/L
• Clay Adams Condley, MD
• Catherine Condon, APRN
• Chayse Marie Condon
• Clayton Condon, APRN
• Donald Morris Condor Jr., P.T.
• Cole S Condra, MD MSC
• Kelly Elizabeth Condren, PT, DPT
• Carmen Tania Condurache, M.D.
• Dnisha Conely, RBT

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.