Active NPI
Jessica Konkle, M.S.; CCC-SLP
- Speech-Language Pathologist
- Centreville, MI
National Provider Identifier
1821908492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101009541
- Practice address
- 62445 Shimmel Rd
Centreville, MI 49032-9527 - Phone
- (269) 467-5400
- NPI assigned
- Sep 8, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7101009541 | MI | Primary |
Addresses
Primary practice location
62445 Shimmel Rd
Centreville, MI 49032-9527
Mailing address
62445 Shimmel Rd
Centreville, MI 49032-9527
Phone (269) 467-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1821908492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62445 SHIMMEL RD",
"city": "CENTREVILLE",
"state": "MI",
"postal_code": "490329527",
"telephone_number": "269-467-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62445 SHIMMEL RD",
"city": "CENTREVILLE",
"state": "MI",
"postal_code": "490329527",
"telephone_number": "269-467-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONKLE",
"first_name": "JESSICA",
"credential": "M.S.; CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-08",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101009541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Centreville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.