Active NPI
Tyreese Conquest
- Behavior Technician
- Pulaski, VA
National Provider Identifier
1710842802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 72 W Main St
Pulaski, VA 24301-5146 - Phone
- (540) 397-5770
- NPI assigned
- Dec 19, 2025
- Last updated
- Dec 19, 2025
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | VA | Primary |
Addresses
Primary practice location
72 W Main St
Pulaski, VA 24301-5146
Mailing address
72 W Main St
Pulaski, VA 24301-5146
Phone (540) 397-5770
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766102400000",
"number": "1710842802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 W MAIN ST",
"city": "PULASKI",
"state": "VA",
"postal_code": "243015146",
"telephone_number": "540-397-5770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 W MAIN ST",
"city": "PULASKI",
"state": "VA",
"postal_code": "243015146",
"telephone_number": "540-397-5770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONQUEST",
"first_name": "TYREESE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-12-19",
"last_updated": "2025-12-19",
"certification_date": "2025-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pulaski, VA
- Bryan D. Clark, D.O.
- Loree D Clauss, RD
- Columbia Medical Group-Southwest Virginia, in (Pulaski Physicians)
- Commonwealth Hospitalist Group, LLC
- Commonwealth of Virginia State Board of Health (Pulaski County Health Department)
- Raymond Ibarra Cruz, MD
- Benjamin Scott Davidson, M.D.
- Crystal M Davis, FNP-BC
- Glenn Davis, MD
- Linda Sue Davis, RN, GCNS-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.