Individual provider Active NPI

Lydia Conrad

  • Speech-Language Pathologist
  • Gaithersburg, MD
National Provider Identifier
1871038026
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
01327L Issued in MD
Practice address
727 Lake Varuna Dr
Gaithersburg, MD 20878-2171
Phone
(914) 643-5234
NPI assigned
Dec 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 01327L MD Primary

Addresses

Primary practice location

727 Lake Varuna Dr
Gaithersburg, MD 20878-2171

Mailing address

7031 Strathmore St
Apt. 1
Chevy Chase, MD 20815-6214
Phone (207) 249-9836

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
01327LMDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Speech Therapy LLC Speech-Language Pathologist PastSince Nov 22, 2016 Accepting new patients

Organizations & group practices 1

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": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1871038026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7031 STRATHMORE ST",
            "address_2": "APT. 1",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156214",
            "telephone_number": "207-249-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 LAKE VARUNA DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782171",
            "telephone_number": "914-643-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "LYDIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "01327L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.