Individual provider Active NPI

Kelsey Marie Conklin, RN, FNP

  • Family Nurse Practitioner
  • Redmond, OR
National Provider Identifier
1801255120
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201505842NP-PP Issued in OR
Practice address
865 SW Veterans Way
Redmond, OR 97756-2583
Phone
(541) 382-4900
NPI assigned
Feb 15, 2016
Last updated
Jan 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 201041816RN OR
Family Nurse Practitioner 363LF0000X 201505842NP-PP OR Primary

Addresses

Primary practice location

865 SW Veterans Way
Redmond, OR 97756-2583

Mailing address

PO Box 6048
Bend, OR 97708-6048
Phone (541) 382-4900

Other identifiers 1

IdentifierTypeStateIssuer
500706302MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kconklin16905@directmsg.bmctotalcare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20160518001305 OR Practitioner - Nurse Practitioner 0840589651 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

8329 SW Beaverton Hillsdale Hwy
Portland, OR 97225-2215
Phone (503) 414-5160

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
201041816RNORMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Silverton Health Current Accepting new patients
Silverton Health CurrentSince Dec 22, 2023 Accepting new patients
Silverton Health Current Accepting new patients
Legacy Clinics LLC CurrentSince Dec 22, 2023 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Silverton Health Current Accepting new patients
Legacy Meridian Park Hospital CurrentSince Dec 22, 2023 Accepting new patients
Bend Memorial Clinic PC Family CurrentSince Jul 1, 2019 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Dec 22, 2023 Accepting new patients
Silverton Health CurrentSince Dec 22, 2023 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Nov 22, 2023 Accepting new patients
Bend Memorial Clinic PC CurrentSince Jul 1, 2019 Accepting new patients
Legacy Clinics LLC CurrentSince Dec 22, 2023 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Dec 22, 2023 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Dec 22, 2023 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Dec 22, 2023 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Nov 22, 2023 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Dec 22, 2023 Accepting new patients

Locations

2725 SW Cedar Hills Blvd
Ste 250
Beaverton, OR 97005
Phone (503) 413-4060

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1960 NW 167th Pl
Ste 100
Beaverton, OR 97006
Phone (503) 531-3434

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

815 SW Bond St
#100
Bend, OR 97702
Phone (541) 706-2525

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

24988 SE Stark St
Ste 220
Gresham, OR 97030
Phone (503) 674-1580

412 A Ave
Lake Oswego, OR 97034
Phone (503) 635-2496

18010 SW McEwan Rd
Lake Oswego, OR 97035
Phone (503) 525-7500

861 W Main St
Molalla, OR 97038
Phone (503) 829-7344

250 W Marquam St
Mount Angel, OR 97362
Phone (503) 845-2000

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2800 N Vancouver Ave
Ste 230
Portland, OR 97227
Phone (503) 413-2901

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

475 S Columbia River Hwy
Ste 100
Saint Helens, OR 97051
Phone (503) 229-8455

500 N Columbia River Hwy
Ste 6
Saint Helens, OR 97051
Phone (503) 366-5101

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667

335 Fairview St
Silverton, OR 97381
Phone (503) 873-4115

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

1475 Mount Hood Ave
Woodburn, OR 97071
Phone (503) 982-2174

1002 N Boones Ferry Rd
Woodburn, OR 97071
Phone (503) 981-9526

Interoperability endpoints

  • Direct secure messaging: kconklin16905@directmsg.bmctotalcare.com

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 19

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1801255120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6048",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086048",
            "telephone_number": "541-382-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 SW VETERANS WAY",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562583",
            "telephone_number": "541-382-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "OR",
            "license": "201041816RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201505842NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500706302",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kconklin16905@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "865 SW Veterans Way",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977562583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.