William Robert Conrad, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1794-023 Issued in WI

Practice address

720 S Van Buren St
Suite 301
Green Bay, WI 54301-3538

Phone

(920) 433-9400

Fax

(920) 433-9409

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801898564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S VAN BUREN ST",
            "address_2": "SUITE 301",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013538",
            "telephone_number": "920-433-9400",
            "fax_number": "920-433-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S VAN BUREN ST",
            "address_2": "SUITE 301",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013538",
            "telephone_number": "920-433-9400",
            "fax_number": "920-433-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1794-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41994800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tess Conklin, AUD
• Jaelyn Connaughty
• Mary A Connelly, MD
• Shaina Marie Conner, APNP
• Emily Connors
• James Joseph Conrardy I, D.D.S.
• Elaine Therese Conway, MS, LPC
• Brittany Cook, APSW
• Jani Lee Cook, NP
• Donald Ray Cooley Jr., DPT, ATC

• Medical Physician Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Medical Physician Assistant in Wisconsin

• 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.