Vivian A Conde, OTR L CST

Primary specialty

Occupational Health ChiropractorTaxonomy code 111NX0100X

License

1133 Issued in OH

Practice address

41640 Parsons Rd
Lagrange, OH 44050-9513

Phone

(440) 355-8032

Fax

(440) 355-4230

NPI assigned

May 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801001029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "GRAFTON",
            "state": "OH",
            "postal_code": "440440228",
            "telephone_number": "440-355-8032",
            "fax_number": "440-355-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41640 PARSONS RD",
            "city": "LAGRANGE",
            "state": "OH",
            "postal_code": "440509513",
            "telephone_number": "440-355-8032",
            "fax_number": "440-355-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDE",
        "first_name": "VIVIAN",
        "middle_name": "A",
        "credential": "OTR L CST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "OH",
            "license": "1133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "341605134005",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "341605134-01",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "341605134",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gretchen Bishop, MSW, LISW-S
• Cheyenne Tyler Bober
• Carlisle Township
• Mary Cham
• Brian Francis Chutes
• Sabrina Gail Conner
• Gustavo Gomez, M.D.
• Marijane Sue Greene, LPN
• Timothy Michael Hall
• Lula Belle Hamilton

• Occupational Health Chiropractor in Lagrange, OH
• Providers in Lagrange, OH by specialty
• Occupational Health Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.