Individual provider Active NPI

Corbin Curtis Wood, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1013538883
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12757354-1206 Issued in UT
Practice address
24 S 1100 E Ste 101
Salt Lake City, UT 84102-1562
Phone
(801) 355-6468
Fax
(801) 355-3450
NPI assigned
May 2, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA0485 NV
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 12757354-1206 UT Primary

Addresses

Primary practice location

24 S 1100 E Ste 101
Salt Lake City, UT 84102-1562

Mailing address

24 S 1100 E Ste 101
Salt Lake City, UT 84102-1562
Phone (801) 355-6468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, UT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210323002410 NV Practitioner - Physician Assistant 0840607677 Reassigns benefits to 1 organization
I20221220001959 UT Practitioner - Physician Assistant 0840607677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hofmann Arthritis Institute PLLCGroup PAC ID 4688790066, 2 clinicians

Practice addresses (Care Compare)

11613 S State St
Draper, UT 84020-9456
Phone (801) 355-6468

24 S 1100
Suite 101
Salt Lake City, UT 84102-1562
Phone (801) 355-6468

888 5TH St
Elko, NV 89801-3504
Phone (801) 355-6468

Hospital & facility affiliations

  • Holy Cross Hospital - Salt Lake Hospital, Salt Lake City, UT, CCN 460003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0485NVMDPhysician Assistant
12757354-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Damaj Horizon View Medical Center, PC Single Specialty PastSince Jan 1, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cwood@hai1735.srs-direct.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1588377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1013538883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 S 1100 E STE 101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021562",
            "telephone_number": "801-355-6468",
            "fax_number": "801-355-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 S 1100 E STE 101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021562",
            "telephone_number": "801-355-6468",
            "fax_number": "801-355-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "CORBIN",
        "middle_name": "CURTIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-02",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0485",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12757354-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.