Paul S Conkling, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

15699 Issued in CO

Practice address

6881 S Yosemite St
Centennial, CO 80112-1406

Phone

(303) 393-8378

Fax

(720) 872-4902

NPI assigned

Aug 21, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

Interoperability endpoints

• Direct secure messaging: direct@familyeyecliniccentennialco.compulinkdirect.com

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1548376965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6881 S YOSEMITE ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121406",
            "telephone_number": "303-393-8378",
            "fax_number": "720-872-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6881 S YOSEMITE ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121406",
            "telephone_number": "303-393-8378",
            "fax_number": "720-872-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLING",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CO",
            "license": "15699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "15699",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Corneal and Contact Management Optometrist in Centennial, CO
• Providers in Centennial, CO by specialty
• Corneal and Contact Management Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.