Stacey Scot Conrad, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

08001084A Issued in IN

Practice address

8924 E 96TH St
Fishers, IN 46037-9648

Phone

(317) 841-2700

Fax

(317) 841-2733

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Premier Sports Chiropractic of Indiana , P.C.

  • Chiropractor
  • Carmel, IN
  • NPI 1588619951
  NPD (past) Authorized official

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1982656328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 JENNINGS DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460339786",
            "telephone_number": "317-575-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8924 E 96TH ST",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379648",
            "telephone_number": "317-841-2700",
            "fax_number": "317-841-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "STACEY",
        "middle_name": "SCOT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IN",
            "license": "08001084A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100126630A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN NUMBER",
            "identifier": "000000092856",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Anne Conley, LMSW;LSSW
• Tamya Nichole Conley
• Gracyn Conner, OT
• Sandra Jane Conner, MA, LCAC
• Nichole Conrad, RPH
• Susan Conrad
• Convenient Ultrasounds
• Jeanetta Carol Conway, AGACNP-BC
• Heather C Cook-Hoggatt, LMT
• Barbara Lynn Cook, PA

• Sports Physician Chiropractor in Fishers, IN
• Providers in Fishers, IN by specialty
• Sports Physician Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.