Presley Kayln McConkey, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

160007989 Issued in IL

Practice address

61 E Side SQ
Canton, IL 61520-2603

Phone

(309) 649-1572

NPI assigned

May 12, 2021

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Advanced Physical Therapy Services, LTD.

  dba Advanced Rehab and Sports Medicine

  • Physical Therapist
  • Canton, IL
  • NPI 1932367810
  NPD
• Advanced Physical Therapy Services, LTD

  dba Advanced Rehab and Sports Medicine

  • Physical Therapist
  • Bloomington, IL
  • NPI 1437141504
  NPD (past)

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1780268904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 253",
            "city": "FAIRVIEW",
            "state": "IL",
            "postal_code": "614320253",
            "telephone_number": "309-202-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 E SIDE SQ",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202603",
            "telephone_number": "309-649-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONKEY",
        "first_name": "PRESLEY",
        "middle_name": "KAYLN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "160007989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "FAIRVIEW",
            "affiliation": "N",
            "endpointDescription": "home",
            "address_1": "275 Main St",
            "city": "Fairview",
            "state": "IL",
            "country_code": "US",
            "postal_code": "614325079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "FAIRVIEW",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FAIRVIEW",
            "address_1": "275 Main St",
            "city": "Fairview",
            "state": "IL",
            "country_code": "US",
            "postal_code": "614325079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lutheran Social Services of Il
• Hope Michele Marlow, CRNA
• Makenzie Mayall
• John M McCarthy, MD
• Kyle McCarthy, FNP
• Lacey N McMahill, APN
• Philip James Mead, MD
• Elise Marie Mefford, FNP
• Amanda Meyers Broughton, PTA
• Midwest Mobile Anesthesia Consultants, SC

• Physical Medicine & Rehabilitation Physician in Canton, IL
• Providers in Canton, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.