Adam Conilogue, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6075 Issued in OR

Practice address

1401 S Main St Ste 104
Fairfield, IA 52556-3771

Phone

(402) 490-6432

NPI assigned

Oct 22, 2009

Last updated

Jun 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Creighton University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Conilogue PT LLCGroup PAC ID 7416297312, 4 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Conilogue PT LLC

  dba Fairfield Universal Therapy

  • Physical Therapist
  • Fairfield, IA
  • NPI 1811451016
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1932435153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 GLENVIEW CIR",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525563758",
            "telephone_number": "402-490-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S MAIN ST STE 104",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525563771",
            "telephone_number": "402-490-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONILOGUE",
        "first_name": "ADAM",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-22",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "6075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry Wesley Cochran, M.D.
• Jonathan Cohen
• Compassionate Counseling LLC (Compassionate Counseling)
• Kirk D. Condon, BA, CADC
• Conilogue PT LLC (Fairfield Universal Therapy)
• Marte Ellen Connor, RN
• Shawna Marie Cook, LMHC
• Amy Marie Cooper, ARNP
• Christina Cox, MA
• Maurice Neil Crossland, DC

• Physical Therapist in Fairfield, IA
• Providers in Fairfield, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.