Diane Conklin, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

201703379NP-PP Issued in OR

Practice address

2180 Main St
Wailuku, HI 96793-1666

Phone

(808) 242-6464

Fax

(808) 242-4209

NPI assigned

Jul 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Ryan Baker, D.C. P.C.

  • Chiropractor
  • Grants Pass, OR
  • NPI 1336203835
  NPD

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496102400000",
    "number": "1497788012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 MAIN ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931666",
            "telephone_number": "808-242-6464",
            "fax_number": "808-242-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 MAIN ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931666",
            "telephone_number": "808-242-6464",
            "fax_number": "808-242-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2017-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "APRN827",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OR",
            "license": "201703379NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE- CHAMPUS",
            "identifier": "99017685996768",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA - 65CP - HMSA QUEST",
            "identifier": "0257493",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHA",
            "identifier": "431043",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Primary Care Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2017; 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.