Active NPI
Maria Conklin, COTA
- Specialist
- Glendale, AZ
National Provider Identifier
1497947816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1744
- Practice address
- 4113 W Oraibi Dr
Glendale, AZ 85308-7424 - Phone
- (602) 614-6683
- NPI assigned
- Aug 10, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 1744 | AZ | Primary |
Addresses
Primary practice location
4113 W Oraibi Dr
Glendale, AZ 85308-7424
Mailing address
13835 N Tatum Blvd
Ste 9-429
Phoenix, AZ 85032-5590
Phone (480) 204-7475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1744 | AZ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wheels on the Bus Pediatric Therapy | Past | Accepting new patients |
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.
-
- Developmental Disabilities Clinic/Center
- Phoenix, AZ
- NPI 1427488808
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432857600000",
"number": "1497947816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13835 N TATUM BLVD",
"address_2": "STE 9-429",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850325590",
"telephone_number": "480-204-7475",
"fax_number": "602-633-1076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4113 W ORAIBI DR",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853087424",
"telephone_number": "602-614-6683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "MARIA",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-10",
"last_updated": "2015-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AZ",
"license": "1744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.