NPIMap

Individual provider Active NPI

Bryan Richard Conklin, MD PC

  • Family Medicine Physician
  • La Grande, OR
National Provider Identifier
1346334075
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD23049 Issued in OR
Practice address
2011 Fourth Street
La Grande, OR 97850-1200
Phone
(541) 963-4139
Fax
(541) 963-4412
NPI assigned
Oct 3, 2006
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD23049 OR Primary

Addresses

Primary practice location

2011 Fourth Street
La Grande, OR 97850-1200

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Other identifiers 1

IdentifierTypeStateIssuer
228792MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031230000090 OR Practitioner - Family Practice 4688571367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Praxis Health PCGroup PAC ID 8325941446, shared by 5 NPIs, 174 clinicians

Practice addresses (Care Compare)

2011 4TH St
La Grande, OR 97850-2511
Phone (541) 963-4139

354 W Adams Ave
Sisters, OR 97759-2619
Phone (541) 549-9609

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD23049ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Schaefer MD PC Family Medicine Current Accepting new patients
Bryan R Conklin MD PC Family Medicine CurrentSince Jan 1, 2002 Accepting new patients
Praxis Health, PC Family Medicine CurrentSince Aug 1, 2012 Accepting new patients
Praxis Health, PC CurrentSince Aug 1, 2012 Accepting new patients

Locations

2011 4th St
La Grande, OR 97850
Phone (541) 963-4139

710 Sunset Dr
La Grande, OR 97850
Phone (541) 663-3100

Organizations & group practices 4

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1346334075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 FOURTH STREET",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501200",
            "telephone_number": "541-963-4139",
            "fax_number": "541-963-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "BRYAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD23049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228792",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.