Individual provider Active NPI

Karen L Conklin, AGNP

  • Gerontology Nurse Practitioner
  • Hinesville, GA
National Provider Identifier
1902203623
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
GAA-NP005130 Issued in GA
Practice address
455 S Main St Ste 201
Hinesville, GA 31313-4354
Phone
(912) 876-3552
Fax
(912) 876-3556
NPI assigned
Nov 24, 2014
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X GAA-NP005130 GA Primary
Nurse Practitioner 363L00000X GAA-NP005130 GA

Addresses

Primary practice location

455 S Main St Ste 201
Hinesville, GA 31313-4354

Mailing address

455 S Main St Ste 201
Hinesville, GA 31313-4354
Phone (912) 876-3552

Other practice location 1

4124 Kittrell Farms Dr Apt 3
Greenville, NC 27858-8998
Phone (252) 945-7868

Other practice location 2

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 413-6202

Other practice location 3

3681 N Main St
Farmville, NC 27828-1464
Phone (252) 753-7141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20151109000401 NC Practitioner - Nurse Practitioner 7113237850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians East PAGroup PAC ID 1850284571, 104 clinicians

Practice addresses (Care Compare)

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 413-6641

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
152836NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians East, PA CurrentSince Jul 1, 2023 Accepting new patients
Physicians East, P.a. CurrentSince Jul 1, 2023 Accepting new patients
Physicians East PA Past Accepting new patients

Locations

3681 North Main St
#114
Farmville, NC 27828
Phone (252) 753-7141

3681 North Main St
Ste 114
Farmville, NC 27828
Phone (252) 753-7141

1850 W Arlington Blvd
Greenville, NC 27834
Phone (252) 413-6641

4796 Old Tar Rd
Winterville, NC 28590
Phone (252) 353-4111

Interoperability endpoints

  • Direct secure messaging: karenconklin@pepa.medalliesdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1902203623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST STE 201",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134354",
            "telephone_number": "912-876-3552",
            "fax_number": "912-876-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST STE 201",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134354",
            "telephone_number": "912-876-3552",
            "fax_number": "912-876-3556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4124 Kittrell Farms Dr Apt 3",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278588998",
            "country_code": "US",
            "telephone_number": "252-945-7868",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 W Arlington Blvd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278345704",
            "country_code": "US",
            "telephone_number": "252-413-6202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3681 N Main St",
            "address_purpose": "LOCATION",
            "city": "Farmville",
            "state": "NC",
            "postal_code": "278281464",
            "country_code": "US",
            "telephone_number": "252-753-7141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "KAREN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-24",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "GAA-NP005130",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "GAA-NP005130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

Verify at the official NPI Registry.