Malcolm O Corley, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

19591 Issued in NC

Practice address

125 Wamsutta Mill Road
Suite D
Morganton, NC 28655-5522

Phone

(828) 430-3511

Fax

(336) 464-2907

NPI assigned

Dec 12, 2006

Last updated

Oct 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Direct Diagnostic Services, LLC

  • Physiological Laboratory
  • Charleston, SC
  • NPI 1801040274
  NPD
• Bamberg County Memorial Hospital

  • Rural Acute Care Hospital
  • Bamberg, SC
  • NPI 1124051834
  NPD (past)
• Coastal Plains Physician Associates

  • Diagnostic Radiology Physician
  • Varnville, SC
  • NPI 1316992506
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1073673562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WAMSUTTA MILL ROAD",
            "address_2": "SUITE B",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286555522",
            "telephone_number": "828-430-3511",
            "fax_number": "336-464-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WAMSUTTA MILL ROAD",
            "address_2": "SUITE D",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286555522",
            "telephone_number": "828-430-3511",
            "fax_number": "336-464-2907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2962 Sweetleaf Ln",
            "address_purpose": "LOCATION",
            "city": "Johns Island",
            "state": "SC",
            "postal_code": "294556710",
            "country_code": "US",
            "telephone_number": "828-430-3511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Carriage Ln Ste 108",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294076048",
            "country_code": "US",
            "telephone_number": "828-430-3511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "MALCOLM",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "5520",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "19591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400685",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Paul Cope, D.O.
• Cora's Cottage 1 LLC
• Cora's Cottage 2 LLC
• Cora's House LLC
• Cordium Links, LLC
• Donald Joseph Costic, M.D.
• Country Pines 1
• Country Pines Family Care Home (Country Pines II)
• County of Burke (Burke County Department of Social Services)
• County of Burke (Burke County Health Dept-Clinic Service)

• Diagnostic Radiology Physician in Morganton, NC
• Providers in Morganton, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.