Eileen F Conklin, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704163261 Issued in MI

Practice address

829 N Center Ave
Suite 210
Gaylord, MI 49735-1595

Phone

(989) 731-7860

Fax

(989) 731-7830

NPI assigned

Jul 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Pro-Health Medical FP

  • Primary Care Clinic/Center
  • Lake Orion, MI
  • NPI 1740841451
  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375
  Medicare reassignment NPD
• Bay Street Orthopaedics PLLC

  • Orthopaedic Surgery Physician
  • Petoskey, MI
  • NPI 1174808992
  Medicare reassignment
• Walloon Lake Recovery Lodge, LLC

  • Substance Abuse Rehabilitation Facility
  • Boyne Falls, MI
  • NPI 1750791505
  NPD

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1487844122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 MCCOY RD W",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497358253",
            "telephone_number": "989-731-7708",
            "fax_number": "989-731-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE",
            "address_2": "SUITE 210",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351595",
            "telephone_number": "989-731-7860",
            "fax_number": "989-731-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "EILEEN",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704163261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Anastasia Cleminson, MD
• Luis Raul Collazo, M.D.
• Garrick Collins, DO
• Philomena Marie Colucci, D.O.
• Community Home & Health Services LLC
• Samantha Paige Conklin, SLP
• Shelley Ann Conley, ATC, OTC
• Patrick Allan Cosgrove, P.T.
• Terrance Mark Cottle, M.A., L.M.S.W.
• Stacy Lynn Couch, LLMSW

• Family Nurse Practitioner in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.