Oksana Konko

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

266782 Issued in AZ

Practice address

1655 N Tegner St
Wickenburg, AZ 85390-1461

Phone

(928) 668-1999

NPI assigned

Dec 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Southwest Kidney Institute, PLC

  • Nephrology Physician
  • Tempe, AZ
  • NPI 1659316008
  NPD (past)

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1447918321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 S POWER RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 N TEGNER ST",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901461",
            "telephone_number": "928-668-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2420 W Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852831040",
            "country_code": "US",
            "telephone_number": "928-293-1836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONKO",
        "first_name": "OKSANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "266782",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "266782",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "266782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troy Conlin Jones, D.M.D.
• Diane Elizabeth Juillard, DO
• KC'S Home Healthcare LLC
• Edward F Kirk, D.D.S.
• Kokopelli Eye Care PC
• Todd M. Kravetz, M.D.
• Carrie Kray, LCSW
• Laboratory Corporation of America
• Christopher Thomas Larson
• Courtney Leboeuf, PMHNP-BC

• Adult Health Nurse Practitioner in Wickenburg, AZ
• Providers in Wickenburg, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.