Melinda Lee Conklin, OT

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

0119001517 Issued in VA

Practice address

1220 Crozet Ave
Crozet, VA 22932-3163

Phone

(434) 823-4307

NPI assigned

Dec 1, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1982209771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 CROZET AVE",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323163",
            "telephone_number": "434-823-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 CROZET AVE",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323163",
            "telephone_number": "434-823-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "MELINDA",
        "middle_name": "LEE",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "VA",
            "license": "0119001517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Crozet",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1220 Crozet Ave",
            "city": "Crozet",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229323163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brandan Clifford, OTR/L
• Kevin M. Clifford, DDS
• Amy Zaiser Cobert, SLP
• Charles Willson Cocke, DPT
• Laura Frances Coleman, PT
• Afton Michelle Cordoba, LPC
• Crozet Blue Ridge Dental, PLC
• Crozet Childrens Health Center PC
• Crozet Eye Care, Shannon Franklin, OD, LLC
• Crozet Internal Medicine, PLC

• All providers in Crozet, VA
• Gerontology Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.