Corey Wayne Dorman, APRN
Individual provider Active NPI Family Nurse Practitioner · Beebe, AR
NPI 1003465618 · NPPES record last updated Dec 21, 2021
Key facts
- NPI
- 1003465618
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 121555 (AR)
- Practice address
- 2069 W. Center St.
Beebe, AR 72012-6873 - Phone
- (501) 628-9212
- Fax
- (501) 232-9501
- NPI assigned
- Sep 6, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Urgent Team of Arkansas Physicians LLC
Practice addresses (Care Compare)
2069 W Ctr St
Beebe, AR 72012-2544
Phone (501) 628-9212
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200918000100 | AR | Practitioner - Nurse Practitioner | 8123446499 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121555 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Palliative Care, LLC | Current |
Accepting new patients |
Locations
14 Parkstone Cir
#C
North Little Rock, AR 72116
Phone (501) 748-3333
14 Parkstone Cir
North Little Rock, AR 72116
Phone (501) 748-3333
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 121555 | AR | Yes |
Addresses
Primary practice location
2069 W. Center St.
Beebe, AR 72012-6873
Mailing address
2069 W. Center St.
Beebe, AR 72012-6873
Phone (501) 628-9212
Other providers in Beebe, AR
- Douglas Edmond De Saint-Felix
- Destination Education, LLC
- Dewey R McAfee DO PA
- Erica M Dexter
- Alexa Donley
- Lauren Douell
- Stacy Driskill
- Angela Nicole Drury
- Dunlap Chiropractic, PLLC
- Andrew Barry Dunlap
All providers in Beebe, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.