Individual provider Active NPI

Donna Conklin, RNFA

  • Medical-Surgical Registered Nurse
  • El Paso, TX
National Provider Identifier
1275619132
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
567401 Issued in TX
Practice address
1771 Tommy Aaron
El Paso, TX 79936
Phone
(915) 822-1988
Fax
(915) 821-9581
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 567401 TX Primary

Addresses

Primary practice location

1771 Tommy Aaron
El Paso, TX 79936

Mailing address

1771 Tommy Aaron
El Paso, TX 79936
Phone (915) 822-1988

Other identifiers 2

IdentifierTypeStateIssuer
50289OtherTXPRESBYTERIAN SALUD PROVID
0004HTOtherTXBC/BS PROVIDER NUMBER

Other names 1

  • Mrs. Donna Canavan Other name

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

State licenses

LicenseStateTypeSpecialty
567401TXMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275619132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 TOMMY AARON",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79936",
            "telephone_number": "915-822-1988",
            "fax_number": "915-821-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 TOMMY AARON",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79936",
            "telephone_number": "915-822-1988",
            "fax_number": "915-821-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "DONNA",
        "name_prefix": "Mrs.",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TX",
            "license": "567401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN SALUD PROVID",
            "identifier": "50289",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "0004HT",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "CANAVAN",
            "prefix": "MRS.",
            "credential": "RNFA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.