Stacy Rebecca Conrad, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1976 Issued in TN

Practice address

5301 Highway 153
Hixson, TN 37343-4912

Phone

(423) 877-9990

NPI assigned

Jun 22, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Torrey J. Carlson & Associates

  • Optometrist
  • Kingsport, TN
  • NPI 1366480964
  Medicare reassignment NPD
• TN Doctors of Optometry, PLLC

  • Optometrist
  • Collierville, TN
  • NPI 1538827050
  Medicare reassignment NPD
• TN Doctors of Optometry, PLLC

  • Eyewear Supplier
  • Kingsport, TN
  • NPI 1275299562

  Optometrist

  NPD

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1902802176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8015 MILL CREEK RD",
            "city": "SIGNAL MOUNTAIN",
            "state": "TN",
            "postal_code": "373771734",
            "telephone_number": "423-886-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 HIGHWAY 153",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434912",
            "telephone_number": "423-877-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "STACY",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2010-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1976",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1809",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "3944233",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902802176",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Dyan Collier, DPT
• Victoria Collier, MD
• Compassionate Health Care LLC
• David Alexander Condra
• Molly M. Connolly, SPTL
• Julianna Michele Cook, NP-C
• Thomas A Cook, MD
• Cornelius J. Mance, M.D., P.C.
• Yvonne Jeanette Coulter, PT
• Kristin Heck Coverly, PHARM D

• All providers in Hixson, TN
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.