Tammy Conklin

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

016417-01 Issued in NY

Practice address

206 Maryland Ave
McComb, MS 39648-3926

Phone

(601) 250-4815

NPI assigned

Nov 6, 2007

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Select PT, OT & SLP Rehabilitation Ny PLLC

  • Rehabilitation Clinic/Center
  • Hudson, NY
  • NPI 1457026353

  NY

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 29, 2021.

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1366622425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 CHURCHLAND RD",
            "city": "SAUGERTIES",
            "state": "NY",
            "postal_code": "124774649",
            "telephone_number": "845-665-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MARYLAND AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483926",
            "telephone_number": "601-250-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "TAMMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103318",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016417-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chasity Combs, PCMHT
• Elma Ladoris Commadore, RN
• Compassionate Medical Services, Inc.
• Milton D Concannon, MD
• Kizzy Renee Coney, RN
• Kim Cooke
• Llewellyn Coon, CNFP
• Ramonda Copeland
• Julie Copenhaver
• Paula Cotton

• All providers in McComb, MS
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.