Samantha A. Conklin, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704272673 Issued in MI

Practice address

580 W College Ave
Marquette, MI 49855-2736

Phone

(906) 228-9440

NPI assigned

Jul 22, 2014

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Concierge Dermatology and Skin Surgery CenterGroup PAC ID 8123377405, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samantha.conklin@mghvi.directbygreenway.com

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.

• Concierge Dermatology & Skin Surgery Center

  • MOHS-Micrographic Surgery Physician
  • Hancock, MI
  • NPI 1417442898
  Medicare reassignment Care Compare group NPD
• DLP Marquette Physician Practices Inc

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995

  Nurse Practitioner

  Medicare reassignment NPD
• DLP Marquette Physician Practices Inc

  • Emergency Medicine Physician
  • Marquette, MI
  • NPI 1366790727
  NPD (past)

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1750798799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552736",
            "telephone_number": "906-228-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "SAMANTHA",
        "middle_name": "A.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704272673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Joseph Columb, DPT, OCS, MT(ASCP)
• Community Connection Counseling
• Isabella Cristina Comsa McCormack, DO
• Jessa A Coniglio, PT
• Jeffrey Allen Conklin, M.D.
• Michael K Conley, MD
• Keith Connolly, MD
• Rachelle Connon, OTR/L
• Constance G. Arnold, M.D.,P.C.
• Ann Christine Constance, MA, RDN, CDE, FAADE

• Nurse Practitioner in Marquette, MI
• Providers in Marquette, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.