Organization Active NPI

Thomas R Conklin MD a Professional Corporation

  • Ophthalmology Physician
  • Reno, NV
National Provider Identifier
1922175173
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
3484 Issued in NV
Legal business name
THOMAS R CONKLIN MD A PROFESSIONAL CORPORATION
Practice address
294 E Moana LN
Suite 22
Reno, NV 89502-4641
Phone
(775) 329-2020
Fax
(775) 827-0843
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Authorized official

Name
Thomas R Conklin, MD
Title
President
Phone
(775) 329-2020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 3484 NV Primary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X C033718 CA

Addresses

Primary practice location

294 E Moana LN
Suite 22
Reno, NV 89502-4641

Mailing address

294 East Moana Lane
Suite 22
Reno, NV 89502-4634
Phone (775) 329-2020

Other identifiers 1

IdentifierTypeStateIssuer
002016648MedicaidNV

Other names 1

  • CENTER FOR CLEAR VISION Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1922175173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 EAST MOANA LANE",
            "address_2": "SUITE 22",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895024634",
            "telephone_number": "775-329-2020",
            "fax_number": "775-827-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 E MOANA LN",
            "address_2": "SUITE 22",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895024641",
            "telephone_number": "775-329-2020",
            "fax_number": "775-827-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS R CONKLIN MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "775-329-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "3484",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C033718",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002016648",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTER FOR CLEAR VISION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.