Individual provider Active NPI

Brandon Nelson Conrad, M.D.

  • Internal Medicine Physician
  • Lexington, KY
National Provider Identifier
1841428059
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47034 Issued in KY
Practice address
168 E Reynolds Rd Ste 110
Lexington, KY 40517-1242
Phone
(859) 494-9072
Fax
(859) 269-0948
NPI assigned
Jun 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 47034 KY Primary

Addresses

Primary practice location

168 E Reynolds Rd Ste 110
Lexington, KY 40517-1242

Mailing address

1152 Iron Lace CT
Lexington, KY 40509-2343
Phone (859) 494-9072

Other practice location 1

1448 Diederich Blvd
Russell, KY 41169-1719
Phone (606) 371-2369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140825000752 KY Practitioner - Internal MedicinePractitioner - Addiction Medicine 6608094263 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Urgent Care LLC Current Accepting new patients
Bluegrass Urgent Care LLC CurrentSince Nov 1, 2019 Accepting new patients
Buc Newport LLC CurrentSince Nov 1, 2019 Accepting new patients
Buc Independence LLC CurrentSince Nov 1, 2019 Accepting new patients
Supportive Med PastSince Apr 27, 2025 Accepting new patients

Locations

401 E 20th St
Covington, KY 41014
Phone (859) 283-6600

2327 Buttermilk Xing
Crescent Springs, KY 41017
Phone (859) 344-7900

2025 Declaration Dr
Independence, KY 41051
Phone (859) 363-3330

625 Chestnut Dr
Ste 106
Walton, KY 41094
Phone (859) 485-7900

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1841428059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 IRON LACE CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092343",
            "telephone_number": "859-494-9072",
            "fax_number": "859-269-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 E REYNOLDS RD STE 110",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405171242",
            "telephone_number": "859-494-9072",
            "fax_number": "859-269-0948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1448 Diederich Blvd",
            "address_purpose": "LOCATION",
            "city": "Russell",
            "state": "KY",
            "postal_code": "411691719",
            "country_code": "US",
            "telephone_number": "606-371-2369",
            "fax_number": "606-324-0447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "BRANDON",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "47034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.