Kelli Marie Conklin

Primary specialty

Chore ProviderTaxonomy code 372500000X

License

315663 Issued in NY

Practice address

449 Ivory Rd
Frewsburg, NY 14738-9724

Phone

(716) 467-2398

NPI assigned

Sep 16, 2014

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Kelli Satterfield Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 16, 2014.

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1811399348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 IVORY RD",
            "city": "FREWSBURG",
            "state": "NY",
            "postal_code": "14738",
            "telephone_number": "716-467-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 IVORY RD",
            "city": "FREWSBURG",
            "state": "NY",
            "postal_code": "147389724",
            "telephone_number": "716-467-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "KELLI",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NY",
            "license": "315663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "SATTERFIELD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cherie Ann Anderson, RN
• Saima Batool
• Amy Carmen, RN
• Julie R Clark, MA CCC SLP L
• Terra Lynne Devereaux, MS, CCC-SLP/L
• Frewsburg Central School District
• Frewsburg Fire District
• Frewsburg Rest Home, Inc.
• Roxy Dove Gray, RN

• All providers in Frewsburg, NY
• Chore Provider in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.