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Physician Compare National (NPI:1841428059)

HEALTHCARE PROVIDER: BRANDON NELSON CONRAD M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1841428059
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 6608094263
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20140825000752
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name CONRAD
Individual professional last name
Provider First Name BRANDON
Individual professional first name
Provider Middle Name NELSON
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Individual professional's medical school
Graduation Year 2009
Individual professional's medical school graduation year
Primary Specialty INTERNAL MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name BLUEGRASS URGENT CARE LLC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 9830350685
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 6
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 625 CHESTNUT DR
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 106
Group Practice or individual's line 2 address
City WALTON
Group Practice or individual's city
State KY
Group Practice or individual's state
Zip Code 410947845
Group Practice or individual's zip code (9 digits when available)
Phone Number 8594857900
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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