Data Notice: All results sourced from the public CMS NPPES NPI Registry (45 CFR Part 162), for healthcare administrative use only (credentialing, billing, insurance verification). Not for law enforcement or legal proceedings. Not affiliated with CMS, HHS, or the US Government. Verify critical details at npiregistry.cms.hhs.gov. No queries stored.
Export Provider Record NPI 1114761053
Samantha ConklinFNP-C
Active
NPI Number1114761053
NPI TypeNPI-1 Individual
SpecialtyNurse Practitioner, Primary Care
Provider Details
NPI1114761053
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2024-06-25
Last Updated2024-06-26
Mailing Address819 S Salina St
Syracuse, NY 13202-3570
United States
📍 View Map
Primary Practice Address930 S Salina St
Syracuse, NY 13202-3530
United States
Phone: (315) 476-7921
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes363LP2300X – Nurse Practitioner, Primary CareNYF352051-01
Export Provider Record NPI 1114761053
Search for More Providers
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →

About NPI 1114761053

Samantha Conklin FNP-C is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1114761053. The primary specialty listed is Nurse Practitioner, Primary Care. The provider is located in Syracuse, NY. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2024-06-25. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1114761053?

NPI 1114761053 belongs to Samantha Conklin FNP-C, a Nurse Practitioner, Primary Care in Syracuse, NY. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1114761053 active?

The current status of NPI 1114761053 in the NPPES registry is Active. The record was last updated on 2024-06-26.

What specialty is NPI 1114761053?

NPI 1114761053 is classified under the taxonomy Nurse Practitioner, Primary Care. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1114761053?

You can verify NPI 1114761053 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1114761053?

The primary practice address on file for NPI 1114761053 is 930 S Salina St, Syracuse, NY 13202-3530. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1114761053 issued?

NPI 1114761053 was first issued (enumerated) on 2024-06-25. The NPPES record was last updated on 2024-06-26.

Practice Location Map

Samantha Conklin is located at 930 S Salina St, Syracuse, NY. Use the map below to find directions or verify the practice location.

📍 930 S Salina St, Syracuse, NY 13202-3530  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Samantha Conklin. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1114761053. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Nurse Practitioner, Primary CareF352051-01NY
Data Verified from CMS NPPES Last synced: 2026-08-12 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162