Organization Active NPI

Conrad Chiropractic & Wellness LLC

  • Clinic/Center
  • Colorado Springs, CO
National Provider Identifier
1992841902
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CONRAD CHIROPRACTIC & WELLNESS LLC
Practice address
5962 Stetson Hills Blvd
Colorado Springs, CO 80922-3579
Phone
(719) 596-8700
Fax
(719) 596-8704
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Shane Reed Conrad, D.C.NPI 1184712036
Title
Owner
Phone
(719) 596-8700

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X CO Primary

Addresses

Primary practice location

5962 Stetson Hills Blvd
Colorado Springs, CO 80922-3579

Mailing address

5962 Stetson Hills Blvd
Colorado Springs, CO 80922-3579
Phone (719) 596-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070329000023 CO Part B Supplier - Clinic/Group Practice 1951405000 Receives reassigned benefits from 3 practitioners
Practice locations: Colorado Spring, CO

National Provider Directory

National Provider Directory

Locations

5928 Stetson Hills Blvd
Ste 100
Colorado Springs, CO 80923
Phone (719) 596-8700

5962 Stetson Hills Blvd
Colorado Springs, CO 80923
Phone (719) 573-8664

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992841902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5962 STETSON HILLS BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809223579",
            "telephone_number": "719-596-8700",
            "fax_number": "719-596-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5962 STETSON HILLS BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809223579",
            "telephone_number": "719-596-8700",
            "fax_number": "719-596-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONRAD CHIROPRACTIC & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-596-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.