NPIMap

Individual provider Active NPI

Kendra Jo Conkright, M.D.

  • Internal Medicine Physician
  • Pittsfield, IL
National Provider Identifier
1053556647
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036141914 Issued in IL
Practice address
320 N Madison St
Pittsfield, IL 62363-1412
Phone
(217) 285-9601
NPI assigned
Dec 10, 2008
Last updated
Nov 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2010024508 MO
Internal Medicine Physician 207R00000X 036141914 IL Primary
Pediatrics Physician 208000000X 036141914 IL

Addresses

Primary practice location

320 N Madison St
Pittsfield, IL 62363-1412

Mailing address

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161109001224 IL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8224153994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

320 N Madison St
Pittsfield, IL 62363-1412
Phone (217) 285-9601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2010024508MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Nov 14, 2016 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Current Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Nov 14, 2016 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Past Accepting new patients

Locations

320 N Madison St
Pittsfield, IL 62363
Phone (217) 285-9601

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1053556647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N MADISON ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631412",
            "telephone_number": "217-285-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKRIGHT",
        "first_name": "KENDRA",
        "middle_name": "JO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2010024508",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036141914",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036141914",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, IL

Sources for this page

Verify at the official NPI Registry.