Individual provider Active NPI

Onnie John Conkin

  • Occupational Therapist
  • Johnson City, TN
National Provider Identifier
1083504286
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3990 Issued in TN
Practice address
140 Technology LN
Johnson City, TN 37604-2004
Phone
(423) 434-2016
Fax
(423) 979-0798
NPI assigned
Jul 8, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3990 TN Primary

Addresses

Primary practice location

140 Technology LN
Johnson City, TN 37604-2004

Mailing address

140 Technology LN
Johnson City, TN 37604-2004
Phone (423) 434-2016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3990TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1083504286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 TECHNOLOGY LN",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042004",
            "telephone_number": "423-434-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 TECHNOLOGY LN",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042004",
            "telephone_number": "423-434-2016",
            "fax_number": "423-979-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKIN",
        "first_name": "ONNIE",
        "middle_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "3990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.