Active NPI
Jill Alison Conkle, PHYSICIAN ASSISTANT
- Physician Assistant
- Xenia, OH
National Provider Identifier
1144390394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50000288
- Practice address
- 1141 N Monroe Dr
Xenia, OH 45385-1619 - Phone
- (937) 372-3638
- Fax
- (937) 372-3642
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50000288 | OH | Primary |
Addresses
Primary practice location
1141 N Monroe Dr
Xenia, OH 45385-1619
Mailing address
2110 Leiter Rd
Miamisburg, OH 45342-3660
Phone (937) 914-7054
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50000288 | Other | OH | OHIO LICENSE |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Dayton Heart Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Dayton, OH
- NPI 1558363762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379376000000",
"number": "1144390394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 LEITER RD",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453423660",
"telephone_number": "937-914-7054",
"fax_number": "937-522-7685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 N MONROE DR",
"city": "XENIA",
"state": "OH",
"postal_code": "453851619",
"telephone_number": "937-372-3638",
"fax_number": "937-372-3642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLE",
"first_name": "JILL",
"middle_name": "ALISON",
"name_prefix": "Miss",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2013-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50000288",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO LICENSE",
"identifier": "50000288",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Xenia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.