Active NPI
Kristie Marie Conklin, OTR
- Occupational Therapist
- Kawkawlin, MI
National Provider Identifier
1306184742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201005430
- Practice address
- 1085 S Mackinaw Rd
Kawkawlin, MI 48631-9430 - Phone
- (989) 297-0387
- NPI assigned
- Jan 18, 2013
- Last updated
- Jan 18, 2013
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201005430 | MI | Primary |
Addresses
Primary practice location
1085 S Mackinaw Rd
Kawkawlin, MI 48631-9430
Mailing address
1085 S Mackinaw Rd
Kawkawlin, MI 48631-9430
Phone (989) 297-0387
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7376 Glen Eagle Dr
Bay City, MI 48706-9316
Phone (989) 992-1367
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Rehab LLC | Occupational Therapist | Current | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358467200000",
"number": "1306184742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1085 S MACKINAW RD",
"city": "KAWKAWLIN",
"state": "MI",
"postal_code": "486319430",
"telephone_number": "989-297-0387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1085 S MACKINAW RD",
"city": "KAWKAWLIN",
"state": "MI",
"postal_code": "486319430",
"telephone_number": "989-297-0387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "KRISTIE",
"middle_name": "MARIE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-18",
"last_updated": "2013-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201005430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kawkawlin, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.