Individual provider Active NPI

Maryellen Conrad, LMT

  • Massage Therapist
  • Poughkeepsie, NY
National Provider Identifier
1841066602
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
005854-01 Issued in NY
Practice address
80 Washington St Ste 301
Poughkeepsie, NY 12601-2316
Phone
(845) 471-2256
NPI assigned
Dec 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 005854-01 NY Primary

Addresses

Primary practice location

80 Washington St Ste 301
Poughkeepsie, NY 12601-2316

Mailing address

80 Washington St Ste 301
Poughkeepsie, NY 12601-2316
Phone (845) 471-2256

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

State licenses

LicenseStateTypeSpecialty
005854-01NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1841066602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 WASHINGTON ST STE 301",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126012316",
            "telephone_number": "845-471-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 WASHINGTON ST STE 301",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126012316",
            "telephone_number": "845-471-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "MARYELLEN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "005854-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.