Active NPI
Jenna Conklin, PT, DPT
- Physical Therapist
- Richardson, TX
National Provider Identifier
1164833950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1242566
- Practice address
- 2201 N Central Expy
Suite 110
Richardson, TX 75080-2754 - Phone
- (214) 265-1819
- Fax
- (214) 373-9530
- NPI assigned
- May 14, 2014
- Last updated
- Jan 30, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1242566 | TX | Primary |
Addresses
Primary practice location
2201 N Central Expy
Suite 110
Richardson, TX 75080-2754
Mailing address
1007 Santa Fe St
Atchison, KS 66002-2339
Phone (214) 497-4932
Other names 1
- Jenna Buckman
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1242566 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lissa D. Mills, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Comprehensive Therapy Services
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Richardson, TX
- NPI 1477639201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580342400000",
"number": "1164833950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 SANTA FE ST",
"city": "ATCHISON",
"state": "KS",
"postal_code": "660022339",
"telephone_number": "214-497-4932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 N CENTRAL EXPY",
"address_2": "SUITE 110",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750802754",
"telephone_number": "214-265-1819",
"fax_number": "214-373-9530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "JENNA",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-14",
"last_updated": "2020-01-30",
"certification_date": "2020-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1242566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNA",
"last_name": "BUCKMAN",
"credential": "PT, DPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Richardson, TX
- Complete Surgical Care LLC
- Comprehensive Hospital Care Solutions LLC
- Comprehensive Neurology Specialists PLLC
- Comprehensive Orthopaedics & Rehabilitation, P.a.
- Megan Conant, OTR
- Connect Behavioral Therapy Center, LLC
- Connections Home Therapy LLC
- Consana Health Services LLC (Consana Health)
- Chiara Catherine Contreras Romanelli, DDS, CAGS, MSD
- Allan Odell Cook Jr., M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.