Madison Bryant Corley, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

302201 Issued in LA

Practice address

7301 Hennessy Blvd Ste 200
Baton Rouge, LA 70808-4794

Phone

(225) 766-0050

NPI assigned

Jul 22, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcorley25744@direct.casso.us.com

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.

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  Medicare reassignment
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  Medicare reassignment
• Our Lady of the Lake Physician Group LLC

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  • NPI 1033494943
  Medicare reassignment
• Professional Emergency Physician Associates, LLC

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  • Baton Rouge, LA
  • NPI 1992758247
  Medicare reassignment
• St. John Emergency Group LLC

  • Emergency Medicine Physician
  • La Place, LA
  • NPI 1265401509
  Medicare reassignment
• Lsuhn Billing LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Baton Rouge, LA
  • NPI 1306247556
  NPD
• Our Lady of the Lake Physician Group LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD
• Our Lady of the Lake Physician Group LLC

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1083067235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98035",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708989035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 HENNESSY BLVD STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084794",
            "telephone_number": "225-766-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 W Esplanade Ave",
            "address_purpose": "LOCATION",
            "city": "Kenner",
            "state": "LA",
            "postal_code": "700652467",
            "country_code": "US",
            "telephone_number": "504-468-8600",
            "fax_number": "504-464-8538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16 Infirmary Rd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708034794",
            "country_code": "US",
            "telephone_number": "225-578-6761",
            "fax_number": "225-578-0596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "MADISON",
        "middle_name": "BRYANT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-22",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "302201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcorley25744@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mcorley25744@direct.casso.us.com",
            "address_1": "16 Infirmary Rd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708034794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "16 Infirmary Rd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708034794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Corey a. Robertson, a Professional Dental Corporation
• Corey a. Robertson, DDS a Professional Dental Corporation
• Corey Hall MD LLC
• Marcus Corkern, DDS
• Kashon Corley, LPC
• Victoria Corley
• Devin Corlin
• Carli Whiteside Cormier, PT, DPT
• Glenn Cormier, CRNA
• Robert N Cormier, CRNA

• Physician Assistant in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.