Scott Gerard Conklin, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

022229 Issued in LA

Practice address

619 E Judge Perez Dr
Chalmette, LA 70043-5260

Phone

(504) 309-8837

Fax

(504) 309-8954

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Chalmette Urgent Medical Care, LLC

  • Urgent Care Clinic/Center
  • Chalmette, LA
  • NPI 1821260464
  NPD Authorized official
• Hospital Service District No. 2

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1548263262
  NPD (past)
• Lee Robert Domangue, M.D., a Professional Medical Corporation

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Slidell, LA
  • NPI 1033293790
  NPD (past)
• St. Bernard Open MRI & Imaging Center LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Chalmette, LA
  • NPI 1427262567
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1043385693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 ANGELA ST",
            "city": "ARABI",
            "state": "LA",
            "postal_code": "700321003",
            "telephone_number": "504-415-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E JUDGE PEREZ DR",
            "city": "CHALMETTE",
            "state": "LA",
            "postal_code": "700435260",
            "telephone_number": "504-309-8837",
            "fax_number": "504-309-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "SCOTT",
        "middle_name": "GERARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "022229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "5BC18",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Birdsall Clements, DPT
• Terinsha Coleman
• Maria Guadalupe Colina, FNP
• Leilani Ann Collins
• Community Medical Group- St Bernard Inc
• Macy Elise Cope, FNP-C
• Wanda Marie Cordova
• Core Louisiana Counseling & Recovery Center, LLC
• Ann M Costilow, MSW
• Ailenne Lizet Coulon, FNP

• All providers in Chalmette, LA
• General Practice Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.