Jessica Pan Conklin, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

3500 Piedmont Rd NE Ste 740
Atlanta, GA 30305-1507

Phone

(404) 875-2050

NPI assigned

Sep 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Jie Pan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• The Atlanta Psychology Group

  • Clinical Psychologist
  • Atlanta, GA
  • NPI 1023586773

  Clinical Neuropsychologist

  NPD (past)

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1154870814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 TALLEY ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304125",
            "telephone_number": "617-230-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 PIEDMONT RD NE STE 740",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051507",
            "telephone_number": "404-875-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "JESSICA",
        "middle_name": "PAN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-22",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PAN",
            "middle_name": "JIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan Jonathan Cone, MD
• Shannon Paul Cone, PH.D.
• Robert Dekle Coney, MD
• Coney&Minter Internal Medicine P.C.
• Julia Conforti, PHARMD
• Timothy Scott Conkright, PSY.D.
• Artesse Conley
• Dyana Conley, PHARM D
• James Brandon Conley, PA-C
• Kelly Ann Conley, D.P.T.

• Clinical Neuropsychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Neuropsychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.