Active NPI
Yong Son Corcoran
- Contractor
- Rockledge, FL
National Provider Identifier
1083969760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 1580119145924
- Practice address
- 258 Barton Blvd
Rockledge, FL 32955-2744 - Phone
- (321) 638-8832
- Fax
- (321) 631-8022
- NPI assigned
- Jul 18, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 1580119145924 | FL | Primary |
Addresses
Primary practice location
258 Barton Blvd
Rockledge, FL 32955-2744
Mailing address
258 Barton Blvd
Rockledge, FL 32955-2744
Phone (321) 638-8832
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1580119145924 | FL | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yongs Wig Salon,Inc | Contractor | Current | Accepting new patients |
Locations
258 Barton Blvd
Rockledge, FL 32955
Phone (321) 638-8832
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427414400000",
"number": "1083969760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 BARTON BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329552744",
"telephone_number": "321-638-8832",
"fax_number": "321-631-8022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 BARTON BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329552744",
"telephone_number": "321-638-8832",
"fax_number": "321-631-8022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORCORAN",
"first_name": "YONG",
"middle_name": "SON",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-18",
"last_updated": "2015-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "FL",
"license": "1580119145924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockledge, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.