Individual provider Active NPI

Kelly L Conklin, D.O.

  • Hospitalist Physician
  • Columbus, OH
National Provider Identifier
1861475428
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
34.007113 Issued in OH
Practice address
3555 Olentangy River Rd
Suite 1080
Columbus, OH 43214-3912
Phone
(614) 268-8164
Fax
(614) 268-8406
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34-00-7113 OH
Hospitalist Physician 208M00000X 34.007113 OH Primary

Addresses

Primary practice location

3555 Olentangy River Rd
Suite 1080
Columbus, OH 43214-3912

Mailing address

3555 Olentangy River Rd
Suite 1080
Columbus, OH 43214-3912
Phone (614) 268-8164

Other identifiers 1

IdentifierTypeStateIssuer
2155868MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080520000004 OH Practitioner - Internal Medicine 1052480894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

4885 Olentangy River Rd
Columbus, OH 43214-1952
Phone (614) 326-5665

495 Cooper Rd
Suite 411
Westerville, OH 43081-8723
Phone (380) 898-7235

655 Africa Rd
Westerville, OH 43082-9808
Phone (614) 447-9495

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348
  • Mount Carmel St Ann'S Hospital, Westerville, OH, CCN 360012
  • Mount Carmel New Albany Surgical Hospital Hospital, New Albany, OH, CCN 360266
  • Mount Carmel Dublin Hospital, Dublin, OH, CCN 360375

Merit-based Incentive Payment System (MIPS)

Final score
87.04 of 100Reported as group
Quality
85.5
Improvement activities
40
Cost
83.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Jul 1, 2000 Accepting new patients
Central Ohio Primary Care Physicians Inc Hospitalist Current Accepting new patients
Central Ohio Primary Care Physicians, Inc. Internal Medicine CurrentSince Jul 1, 2000 Accepting new patients
Ohiohealth Corporation Past Accepting new patients
Mount Carmel Health System Past Accepting new patients

Locations

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

3555 Olentangy River Rd
Ste 1080
Columbus, OH 43214
Phone (614) 268-8164

1493 Parsons Ave
Columbus, OH 43207
Phone (614) 444-1040

3535 Fishinger Blvd
Ste 285
Hilliard, OH 43026
Phone (614) 527-2562

570 Polaris Pkwy
Ste 250
Westerville, OH 43082
Phone (614) 459-0216

Interoperability endpoints

  • Direct secure messaging: kconklin18944@copcp.medicity.net

Organizations & group practices 5

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

Hospital & facility affiliations 6

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1861475428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 OLENTANGY RIVER RD",
            "address_2": "SUITE 1080",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143912",
            "telephone_number": "614-268-8164",
            "fax_number": "614-268-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 OLENTANGY RIVER RD",
            "address_2": "SUITE 1080",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143912",
            "telephone_number": "614-268-8164",
            "fax_number": "614-268-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34-00-7113",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "34.007113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2155868",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.