DR. JACOB STEVEN CONRAD (NPI# 1720473135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720473135 |
| Entity Type | Individual |
| Full Name | DR. JACOB STEVEN CONRAD |
| Credential | PHARMD |
| Practice Address |
604 19th St Se Demotte IN 46310-8270 |
| Practice Telephone | 8153837720 |
| Mailing Telephone | 8153837720 |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2015-04-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 26025292A | IN | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 05129787 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942787296 | Jacob Michael Conrad | Dentist | Naval Medical Ctr, San Diego, CA 92134-0001 | 2018-07-19 |
| Street Address |
604 19TH ST SE |
| City | DEMOTTE |
| State | IN |
| Zip Code | 46310-8270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447872197 | Mackenna Lee Vandertuin | Early Intervention Provider Agency | 400 11th Circle Se, Demotte, IN 46310 | 2020-05-15 |
| 1316283609 | Jasper County Chiropractic, Inc. | Chiropractor | 701 South Halleck Street, Demotte, IN 46310 | 2012-12-14 |
| 1518136944 | John Joseph Perry | Pharmacist | 915 S Halleck St, Demotte, IN 46310 | 2008-02-29 |
| 1164644498 | Dodi R. Woolley Dds, Inc | Dentist | 534 N Hallock St, Demotte, IN 46310 | 2007-05-03 |
| 1700989233 | Eric J Leestma | Family Medicine | 519 N Halleck, Demotte, IN 46310 | 2006-09-07 |
| 1215960463 | Keener Civil Township Jasper County Ttee | Ambulance | 708 15th St Se, Demotte, IN 46310 | 2006-07-09 |
| 1437187085 | Cecilia Jean Sampsel | Family Medicine | 520 Eighth Ave N.e, Demotte, IN 46310 | 2006-06-30 |
| 1689602468 | Frances Clark | Nurse Practitioner | 11920 W State Rd 10, Demotte, IN 46310 | 2006-06-29 |
| 1336359801 | Donabelle Reyes Eliscupides | Physical Therapist | 10352 N 600 E, Demotte, IN 46310 | 2007-05-23 |
| 1760691638 | Cheryle Rae Lewandowski | Physical Therapy Assistant | 10352 N 600 E, Demotte, IN 46310 | 2007-05-21 |
| Find all providers in zip 46310 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518136944 | John Joseph Perry | Pharmacist | 915 S Halleck St, Demotte, IN 46310 | 2008-02-29 |
| 1215937958 | Samuel Gurevitz | Pharmacist | 9021 W 1225 N, Demotte, IN 46310-9466 | 2005-07-22 |
| 1699320473 | Darren Lloyd Hartman | Pharmacist | 5765 E State Road 10, Demotte, IN 46310-8888 | 2019-08-07 |
| 1528611332 | Michael Swart | Pharmacist | 325a N Halleck St, Demotte, IN 46310-8670 | 2019-07-21 |
| 1518242833 | Allison Marie Wieser | Pharmacist | 226 N Halleck St, Demotte, IN 46310-8633 | 2011-10-18 |
| 1023393550 | Shannon Sue Frieden | Pharmacist | 226 N Halleck St, Demotte, IN 46310-8633 | 2011-10-16 |
| 1902189343 | Kenneth Ray Pearson | Pharmacist | 226 N Halleck St, Demotte, IN 46310-8633 | 2011-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710728 | Joel Burke Hood | Pharmacist | 5034 E Timberwood Dr, Newburgh, IN 47630-3018 | 2020-11-08 |
| 1346841582 | Autumn Brooke Trifone | Pharmacist | 1795 In 163, Clinton, IN 47842 | 2020-11-04 |
| 1043811326 | Brunhilda K Waingeh | Pharmacist | 4008 Decker Ct, Sellersburg, IN 47172-9258 | 2020-11-04 |
| 1659972834 | Crenda Bottorff | Pharmacist | 1835 East Us 231 South, Crawfordsville, IN 47935 | 2020-11-04 |
| 1114528585 | Shannon Allcron | Pharmacist | 6770 E. Virginia St., Evansville, IN 47715 | 2020-11-03 |
| 1558962860 | Andrea Abbett | Pharmacist | 333 Boyd Blvd Laporte, In 46350, 211 S 75 E, Valparaiso, IN 46383 | 2020-11-03 |
| 1588265052 | Sarah Corder | Pharmacist | 2633 W 450 N, La Porte, IN 46350-7507 | 2020-11-02 |
| 1447851928 | Alicia Helene Wojciechowski | Pharmacist | 5829 N New Jersey St, Indianapolis, IN 46220-2534 | 2020-11-02 |
| 1871194472 | Megan Mccullough | Pharmacist | 10617 East Washington Street, Pharmacy At Walmart, Indianapolis, IN 46222 | 2020-11-02 |
| 1013518646 | Philip Anthony Card | Pharmacist | 823 W State Highway 46 Ste 1p1, Spencer, IN 47460-6748 | 2020-11-02 |
| Find all providers with the same taxonomy | ||||
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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.