Individual provider Active NPI

Claudia F Corradino, MS APN BC

  • Family Nurse Practitioner
  • Bristol, TN
National Provider Identifier
1063623692
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12655 Issued in TN
Practice address
3183 W State St
Suite 1201
Bristol, TN 37620-1712
Phone
(423) 764-0987
Fax
(423) 652-2512
NPI assigned
May 25, 2007
Last updated
Mar 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 12655 TN
Family Nurse Practitioner 363LF0000X 12655 TN Primary

Addresses

Primary practice location

3183 W State St
Suite 1201
Bristol, TN 37620-1712

Mailing address

3183 W State St
Suite 1201
Bristol, TN 37620-1712
Phone (423) 764-0987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20080429000634 TN Practitioner - Nurse Practitioner 9335231992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

3183 W State St
Suite 1201
Bristol, TN 37620-1713
Phone (423) 968-2772

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12655TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Apr 1, 2017 Accepting new patients
Wellmont Medical Associates Inc Nurse Practitioner CurrentSince Apr 1, 2017 Accepting new patients
Blue Ridge Medical Management Corporation Family Past Accepting new patients

Locations

3183 W State St
Ste 1201
Bristol, TN 37620
Phone (423) 764-0987

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1063623692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3183 W STATE ST",
            "address_2": "SUITE 1201",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201712",
            "telephone_number": "423-764-0987",
            "fax_number": "423-652-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3183 W STATE ST",
            "address_2": "SUITE 1201",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201712",
            "telephone_number": "423-764-0987",
            "fax_number": "423-652-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRADINO",
        "first_name": "CLAUDIA",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "MS APN BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "12655",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.