Bryan Allen Corpus, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301090315 Issued in MI

Practice address

601 John St
Suite E352
Kalamazoo, MI 49007-5341

Phone

(269) 341-8986

Fax

(269) 341-6236

NPI assigned

Jun 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@direct.bronsonhg.org

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.

• Bronson Methodist Hospital

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment NPD
• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  NPD (past)

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1104020353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE E352",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8986",
            "fax_number": "269-341-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE E352",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8986",
            "fax_number": "269-341-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORPUS",
        "first_name": "BRYAN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301090315",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301090315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104020353",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "1417961137",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cornerstone Christian Counseling PC
• Cornerstone Counseling Center
• Cornerstone II
• Alexis Cornwell
• Yadira Corona
• David T Corradini
• Gary Corradini, PT
• Matthew Corrado
• Ashley Correia
• Gary Corsaut

• Pediatrics Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.