Active NPI
William Lewis Conklin, MD
- Anesthesiology Physician
- Olympia, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 36242
- Practice address
- 3624 Ensign Rd NE
Ste B
Olympia, WA 98506-5074 - Phone
- (360) 438-6435
- NPI assigned
- Apr 3, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 36242 | WA | Primary |
Addresses
Primary practice location
3624 Ensign Rd NE
Ste B
Olympia, WA 98506-5074
Mailing address
804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (360) 438-6400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Medical College of Wisconsin, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-4101
Hospital & facility affiliations
- Providence St Peter Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36242 | WA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Anesthesia PC | Anesthesiology | Current | Accepting new patients |
Locations
11808 Northup Way
Ste W300
Bellevue, WA 98005
Phone (425) 284-1545
413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480
1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Tacoma, WA
- NPI 1497796452
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Olympia, WA
- NPI 1346250594
-
- General Acute Care Hospital
- Olympia, WA
- NPI 1619176997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394496000000",
"number": "1467414722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 SCOTT NIXON MEMORIAL DR",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309072464",
"telephone_number": "360-438-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3624 ENSIGN RD NE",
"address_2": "STE B",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065074",
"telephone_number": "360-438-6435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "WILLIAM",
"middle_name": "LEWIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-03",
"last_updated": "2014-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "36242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.