Active NPI
Stephanie Marie Corlew
- Athletic Trainer
- Ashtabula, OH
National Provider Identifier
1003389271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1015
- Practice address
- 607 Lake Ave
Ashtabula, OH 44004-3262 - Phone
- (440) 964-2035
- NPI assigned
- Jan 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5853 | OH | |
| Athletic Trainer | 2255A2300X | 1015 | OH | Primary |
Addresses
Primary practice location
607 Lake Ave
Ashtabula, OH 44004-3262
Mailing address
2419 W 11TH St
Ashtabula, OH 44004-2545
Phone (440) 813-3438
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5853 | OH | MD | Physical Therapy Assistant |
| 1015 | OH | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wychock Physical Therapy Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Ashtabula, OH
- NPI 1295916146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546992000000",
"number": "1003389271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2419 W 11TH ST",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440042545",
"telephone_number": "440-813-3438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 LAKE AVE",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440043262",
"telephone_number": "440-964-2035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORLEW",
"first_name": "STEPHANIE",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-09",
"last_updated": "2019-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "5853",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "1015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashtabula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.