Individual provider Active NPI

Kelli Conkin, OTR

  • Occupational Therapist
  • Carmel, IN
National Provider Identifier
1770735425
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31001325A Issued in IN
Practice address
118 Medical Dr
Carmel, IN 46032-2923
Phone
(317) 573-1037
Fax
(866) 785-4924
NPI assigned
Oct 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31001325A IN Primary

Addresses

Primary practice location

118 Medical Dr
Carmel, IN 46032-2923

Mailing address

10877 Monarch Springs CT
Noblesville, IN 46060-8304
Phone (317) 435-1996

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

LicenseStateTypeSpecialty
31001325AINMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1770735425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10877 MONARCH SPRINGS CT",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460608304",
            "telephone_number": "317-435-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MEDICAL DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460322923",
            "telephone_number": "317-573-1037",
            "fax_number": "866-785-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKIN",
        "first_name": "KELLI",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31001325A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.