Victoria Conklin

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

CP025919A Issued in VA

Practice address

800 Monterrosa Dr
Myrtle Beach, SC 29572-8169

Phone

(973) 879-4299

NPI assigned

Jan 22, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1780445213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MONTERROSA DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295728169",
            "telephone_number": "973-879-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MONTERROSA DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295728169",
            "telephone_number": "973-879-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "4590",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "CP025919A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Conard, D.M.D.
• Douglas Conaway, M.D.
• Hanna Condrey, PHARMD
• Karyn Longo Congdon
• Robert J. Coni, D.O.
• Connections Pediatric Therapy
• George Andrew Connell, DC
• Monica Beatrice Constantinescu, M.D.
• Consulting With Science LLC
• Consulting With Science LLC

• Physical Therapy Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.