Individual provider Active NPI

Corom E Hughes, LCSW

  • Clinical Social Worker
  • Provo, UT
National Provider Identifier
1083913222
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5483308-3501 Issued in UT
Practice address
750 N Freedom Blvd
Provo, UT 84601-1677
Phone
(801) 373-4760
NPI assigned
Mar 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 5483308-3502 UT
Clinical Social Worker 1041C0700X 5483308-3501 UT Primary

Addresses

Primary practice location

750 N Freedom Blvd
Provo, UT 84601-1677

Mailing address

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5483308-3502UTMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1083913222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "COROM",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-25",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "UT",
            "license": "5483308-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "5483308-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.