NPIMap

Organization Active NPI

Kimberly Anne Conrad PLC

  • School Counselor
  • Waucoma, IA
National Provider Identifier
1932286085
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School CounselorTaxonomy code 101YS0200X
License
351029 Issued in IA
Legal business name
KIMBERLY ANNE CONRAD PLC
Practice address
100 1St Ave SW
Waucoma, IA 52171-9705
Phone
(563) 776-4060
Fax
(563) 776-4061
NPI assigned
Nov 1, 2006
Last updated
Oct 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Kimberly Anne Conrad, SEDNPI 1619054764
Title
Director
Phone
(319) 240-0944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X 351029 IA Primary
Community/Behavioral Health Agency 251S00000X 06449 IA

Addresses

Primary practice location

100 1St Ave SW
Waucoma, IA 52171-9705

Mailing address

25271 Johnsons Mill Rd
Waucoma, IA 52171-7137
Phone (219) 240-0944

Other identifiers 2

IdentifierTypeStateIssuer
1012617MedicaidIA
0470138MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1932286085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25271 JOHNSONS MILL RD",
            "city": "WAUCOMA",
            "state": "IA",
            "postal_code": "521717137",
            "telephone_number": "219-240-0944",
            "fax_number": "563-776-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 1ST AVE SW",
            "city": "WAUCOMA",
            "state": "IA",
            "postal_code": "521719705",
            "telephone_number": "563-776-4060",
            "fax_number": "563-776-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY ANNE CONRAD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "319-240-0944",
        "authorized_official_credential": "SED"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "IA",
            "license": "351029",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IA",
            "license": "06449",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012617",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0470138",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waucoma, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.