Individual provider Active NPI

Donna Conkling, M.D.

  • Internal Medicine Physician
  • Skowhegan, ME
National Provider Identifier
1407873433
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD11065 Issued in ME
Practice address
46 Fairview Ave
Suite 111
Skowhegan, ME 04976-1481
Phone
(207) 474-0905
Fax
(207) 474-6930
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD11065 ME Primary

Addresses

Primary practice location

46 Fairview Ave
Suite 111
Skowhegan, ME 04976-1481

Mailing address

PO Box 468
Skowhegan, ME 04976-0468
Phone (207) 858-2310

Other identifiers 1

IdentifierTypeStateIssuer
307060099MedicaidME

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317000876 ME Practitioner - Family PracticePractitioner - Emergency Medicine 5991695546 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD11065MEMDInternal Medicine Physician
015294MEMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Aug 1, 1982 Accepting new patients
Mainegeneral Medical Center CurrentSince Aug 1, 1982 Accepting new patients
Redington Medical Associates Past Accepting new patients

Locations

15 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1561

10 Water St
Ste 202
Waterville, ME 04901
Phone (207) 873-9846

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1407873433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049760468",
            "telephone_number": "207-858-2310",
            "fax_number": "207-474-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 FAIRVIEW AVE",
            "address_2": "SUITE 111",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761481",
            "telephone_number": "207-474-0905",
            "fax_number": "207-474-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLING",
        "first_name": "DONNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD11065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307060099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skowhegan, ME

Sources for this page

Verify at the official NPI Registry.