DR. JEFFREY MARK CONRAD (NPI# 1720046600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720046600 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY MARK CONRAD |
| Credential | MD |
| Practice Address |
6144 Airport Blvd Mobile AL 36608-3143 |
| Mailing Address |
Po Box 86144 Mobile AL 36689-6144 |
| Practice Telephone | 2514765050 |
| Practice Fax Number | 2514502770 |
| Mailing Telephone | 2514765050 |
| Mailing Fax Number | 2514502770 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2010-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
00025851 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 009960785 | 05 | |
| RAILROAD MEDICARE | P00143020 | 01 | |
| TAX ID | 631187140 | 01 | |
| AL | BCBS | 051522492 | 01 |
| MS | 05723278 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447768932 | Jeffrey Lane Conrad | Counselor | 360 E Enon Rd, Yellow Springs, OH 45387-1415 | 2018-01-18 |
| Street Address |
6144 AIRPORT BLVD |
| City | MOBILE |
| State | AL |
| Zip Code | 36608-3143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265410658 | Albert Fox Haas | Orthopaedic Surgery | 6144 Airport Blvd, Mobile, AL 36608 | 2006-01-05 |
| 1205489804 | Jonathon Andrew Gibson | Orthopaedic Surgery | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2019-07-23 |
| 1275197212 | Sarah Scott West | Registered Nurse | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2019-04-25 |
| 1508345968 | Vincent Clay Cochran | Physical Therapist | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2018-08-07 |
| 1346756160 | Nicholas K Bolling | Physician Assistant | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2017-12-15 |
| 1770003436 | Katherine Elizabeth Metzger | Occupational Therapist | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2017-06-23 |
| 1275065062 | Adam Robert Smith | Registered Nurse | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2017-03-30 |
| 1912442401 | Christopher Choquette | Registered Nurse | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2016-12-20 |
| 1811448129 | Joshua Glen Pyeatt | Physician Assistant | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2016-10-21 |
| 1174978464 | Amanda Ladner | Registered Nurse | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2016-04-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475524 | Grantham Dental, Inc. | Dentist | 3620 Springhill Memorial Drive South, Mobile, AL 36608 | 2020-10-21 |
| 1114540879 | Dearrius Hines | Home Health Aide | 1370 Lucerne Dr, Mobile, AL 36608 | 2020-05-28 |
| 1558980409 | Rachel Stevens | Registered Nurse | 8507 Tanner Williams Rd, Mobile, AL 36608 | 2020-04-10 |
| 1073170700 | Usa Health Physician Billing Services LLC | Otolaryngology | 5721 Usa Drive North, Hahn 1119, Mobile, AL 36608 | 2019-05-29 |
| 1952885600 | Franklin Primary Health Center Inc. | Dentist | 990 Cody Rd North, Mobile, AL 36608 | 2018-09-19 |
| 1114410040 | Zackary Elkins | Optometrist | 105 W I65 Service Rd N, Mobile, AL 36608 | 2018-06-14 |
| 1023562865 | Covenant Hospice, Inc. | Internal Medicine | 6801 Airport Blvd., Main Tower, 11th Floor North, Mobile, AL 36608 | 2016-08-10 |
| 1730575416 | Rayven Likely | Student in an Organized Health Care Education/Training Program | 1014 Centerwood Dr, Mobile, AL 36608 | 2015-04-09 |
| 1598040461 | Robert S Harlin | Specialist | 75 Clarise Circle, Mobile, AL 36608 | 2011-10-11 |
| 1972884948 | Heidi Michelle Mcdermott | Physical Therapist | 5721 Usa Drive N, Hahn 2050, Mobile, AL 36608 | 2011-09-06 |
| Find all providers in zip 36608 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528084787 | Orthopaedic and Sports Medicine of Mobile, PC | Orthopaedic Surgery | 6701 Airport Blvd, D146, Mobile, AL 36608-6705 | 2006-07-14 |
| 1619934759 | Stephen Bennett Cope | Orthopaedic Surgery | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2006-05-01 |
| 1306803838 | James Michael Cockrell | Orthopaedic Surgery | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013205970 | Daniel Jason Morris | Orthopaedic Surgery | 1446 Jones Dairy Rd Ste 100, Jasper, AL 35501 | 2011-07-13 |
| 1720243421 | Kennieth Charles Mccollough Jr. | Orthopaedic Surgery | 1201 11th Ave S Ste 200, Birmingham, AL 35205 | 2008-07-22 |
| 1013198985 | Graham L. Howorth, M.d., P.C. | Orthopaedic Surgery | 1120 Airport Dr Ste 101, Alexander City, AL 35010-3444 | 2007-11-20 |
| 1114016060 | Michael Antonio Eslava | Orthopaedic Surgery | 1711 N. Mckenzie Street, Foley, AL 36535 | 2006-10-11 |
| 1164449518 | Kenneth Wayne Bramlett | Orthopaedic Surgery | 1021 Montgomery Hwy Ste 201, Vestavia Hills, AL 35216-2805 | 2006-07-15 |
| 1033114327 | Anthony Lynn Tropeano | Orthopaedic Surgery | 209 West Spring Street, Suite 301, Sylacauga, AL 35150-2976 | 2005-06-15 |
| 1619503182 | Timothy Clay Johnson | Orthopaedic Surgery | 1600 7th Ave S, Birmingham, AL 35233-1711 | 2020-03-17 |
| 1205356938 | Alabama State University | Orthopaedic Surgery | 915 S Jackson St, Montgomery, AL 36104-5716 | 2017-06-23 |
| 1578921581 | Stv Sports Medicine and Orthopedics, LLC | Orthopaedic Surgery | 805 Saint Vincents Dr, Suite 100, Birmingham, AL 35205-1636 | 2016-02-04 |
| 1720452428 | Bw Sports Practice, LLC | Orthopaedic Surgery | 13521 Old Highway 280, Ste. 201b, Birmingham, AL 35242-1405 | 2015-11-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.