Active NPI
Andrea Conklin
- Personal Care Attendant
- Tampa, FL
National Provider Identifier
1255804696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- 011824000
- Practice address
- 6323 Newtown Cir Apt A3
Tampa, FL 33615-3616 - Phone
- (561) 317-8815
- NPI assigned
- Jan 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | 011824000 | FL | Primary |
Addresses
Primary practice location
6323 Newtown Cir Apt A3
Tampa, FL 33615-3616
Mailing address
6323 Newtown Cir Apt A3
Tampa, FL 33615-3616
Phone (561) 317-8815
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01182400 | Medicaid | FL |
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 |
|---|---|---|---|
| 011824000 | FL | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546905600000",
"number": "1255804696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6323 NEWTOWN CIR APT A3",
"city": "TAMPA",
"state": "FL",
"postal_code": "336153616",
"telephone_number": "561-317-8815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6323 NEWTOWN CIR APT A3",
"city": "TAMPA",
"state": "FL",
"postal_code": "336153616",
"telephone_number": "561-317-8815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "ANDREA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-08",
"last_updated": "2019-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "FL",
"license": "011824000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01182400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.