NPIMap

Individual provider Active NPI

Jason Carl Conrad, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Lincoln, NE
National Provider Identifier
1932644051
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
075 Issued in NE
Practice address
1124 N Cotner Blvd
Lincoln, NE 68505-1834
Phone
(402) 435-3165
Fax
(402) 435-0430
NPI assigned
Dec 28, 2016
Last updated
Jan 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 075 NE Primary

Addresses

Primary practice location

1124 N Cotner Blvd
Lincoln, NE 68505-1834

Mailing address

1124 N Cotner Blvd
Lincoln, NE 68505-1834
Phone (402) 435-3165

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
075NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Houses of Hope of Nebraska, Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1932644051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 N COTNER BLVD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685051834",
            "telephone_number": "402-435-3165",
            "fax_number": "402-435-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 N COTNER BLVD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685051834",
            "telephone_number": "402-435-3165",
            "fax_number": "402-435-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "JASON",
        "middle_name": "CARL",
        "name_prefix": "Mr.",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-28",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.