Rebekah Soroosh Corley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-03918 Issued in NC

Practice address

658 N Chase St Ste 201
Athens, GA 30601-1960

Phone

(706) 353-2990

NPI assigned

Nov 27, 2012

Last updated

Jul 16, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University Cancer & Blood Center LLC

  • Hematology & Oncology Physician
  • Athens, GA
  • NPI 1346343761
  Medicare reassignment NPD
• University Health Alliance

  • Hematology & Oncology Physician
  • Athens, GA
  • NPI 1972239440
  NPD (past)
• Gaston Gastroenterology, PA

  • Specialist
  • Gastonia, NC
  • NPI 1265489405
  NPD (past)

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1023352358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD BLDG 800",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071400",
            "telephone_number": "706-353-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 N CHASE ST STE 201",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306011960",
            "telephone_number": "706-353-2990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 Old Jefferson Rd Bldg 700",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306071465",
            "country_code": "US",
            "telephone_number": "706-353-2990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1460 Resurgence Dr",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306777320",
            "country_code": "US",
            "telephone_number": "706-715-2410",
            "fax_number": "706-353-2992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "REBEKAH",
        "middle_name": "SOROOSH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Thomas Copeland, M.D.
• Kenneth Stuart Copes, PT
• Christopher Scott Corbett, PSYD
• Stephanie Page Corbett, LCSW
• William Cellaigh Corbitt, PA
• Avery Corneil
• Cornerstone Caregiving East LLC
• Cornerstone Medical Clinic, PC
• Hazael Jane Cortese, RN
• Vito Cortese Jr., RN

• Physician Assistant in Athens, GA
• Providers in Athens, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.