Dianne Louise Conkling, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4076 Issued in NM

Practice address

1000 E Aztec Ave
Gallup, NM 87301-5509

Phone

(505) 721-1845

NPI assigned

Apr 19, 2007

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1841417995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 903",
            "city": "JAMESTOWN",
            "state": "NM",
            "postal_code": "873470903",
            "telephone_number": "505-721-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015509",
            "telephone_number": "505-721-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLING",
        "first_name": "DIANNE",
        "middle_name": "LOUISE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "4076",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "12680",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79059023",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Collom
• Mary Magdalena Colton, CNM
• Community Area Resource Enterprise (Care 66)
• Compassionate Health LLC
• Wanda Lissette Concepcion, RN
• Richard G Conley, RN
• Connections of McKinley County, Inc.
• Stella Connell, RN
• Shavon Elizabeth Conner, RN
• Mary V Conrad, RN

• Speech-Language Pathologist in Gallup, NM
• Providers in Gallup, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.