Kelly Renee Conklin, DNP

Key facts

NPI

1609893395

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

200450145NP (OR)

Practice address

913 NW Garden Valley Blvd
Roseburg, OR 97471

Phone

(541) 440-1000

Fax

(541) 440-1230

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 7

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.

• Icco, LLC Urgent Care Clinic/Center · Eugene, OR · NPI 1407004757
  Medicare reassignment Care Compare group NPD OR
• Icco LLC Rural Health Clinic/Center · Florence, OR · NPI 1740896547
  NPD
• Icco, LLC Physical Therapist · Eugene, OR · NPI 1528385754
  NPD
• Cep America LLC Emergency Medicine Physician · Roseburg, OR · NPI 1780647719
  NPD (past)
• Family Choice Urgent Care LLC Urgent Care Clinic/Center · Bend, OR · NPI 1215388145
  NPD (past)
• Icco, LLC Family Medicine Physician · Eugene, OR · NPI 1992861611
  NPD (past)
• Cep America LLC Emergency Medicine Physician · Edmonds, WA · NPI 1447484274
  NPD (past)

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Commonspirit Oregon General Acute Care Hospital · Roseburg, OR · NPI 1477590198
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icco LLC (133 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital · Roseburg, OR · CCN 380027

Medicare participation

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• Ms. Kelly Renee O'Brien Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 25, 2026.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1609893395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97471",
            "telephone_number": "541-440-1000",
            "fax_number": "541-440-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97471",
            "telephone_number": "541-440-1000",
            "fax_number": "541-440-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "KELLY",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200450145NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER IDENTIFICATION",
            "identifier": "93-1148588",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "O'BRIEN",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Leslie Conlee, BS
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All providers in Roseburg, OR · Family Nurse Practitioner in Oregon