Individual provider Active NPI

Kirsten Alexis Konkel, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Elk Grove, CA
National Provider Identifier
1144620766
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP24676 Issued in CA
Practice address
8788 Elk Grove Blvd
BLDG 3, Suite 12I
Elk Grove, CA 95624
Phone
(916) 467-8344
NPI assigned
Sep 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP24676 CA Primary

Addresses

Primary practice location

8788 Elk Grove Blvd
BLDG 3, Suite 12I
Elk Grove, CA 95624

Mailing address

9313 Edensbury CT
Elk Grove, CA 95758-4137
Phone (916) 831-9494

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP24676CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Joyful Words Speech Therapy Inc. Speech-Language Pathologist CurrentSince Jul 1, 2022 Accepting new patients
Rock Therapeutic Services LLC Speech-Language Pathologist Past Accepting new patients

Locations

8788 Elk Grove Blvd
Ste 12
Elk Grove, CA 95624
Phone (916) 399-3144

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1144620766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9313 EDENSBURY CT",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584137",
            "telephone_number": "916-831-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8788 ELK GROVE BLVD",
            "address_2": "BLDG 3, SUITE 12I",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95624",
            "telephone_number": "916-467-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONKEL",
        "first_name": "KIRSTEN",
        "middle_name": "ALEXIS",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP24676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.