Individual provider Active NPI

Corianne Warrick Vanderkolk, PA-C

  • Physician Assistant
  • Linton, IN
National Provider Identifier
1104267806
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001546 Issued in IN
Practice address
1600 A St NE Ste 9
Linton, IN 47441
Phone
(812) 699-4153
Fax
(812) 699-4271
NPI assigned
Jul 10, 2013
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001546 IN Primary

Addresses

Primary practice location

1600 A St NE Ste 9
Linton, IN 47441

Mailing address

1600 A St NE Ste 9
Linton, IN 47441-1612
Phone (812) 847-7005

Other practice location 1

326 E Main St
Jasonville, IN 47438-1510
Phone (812) 665-9000

Other names 1

  • Corrianne Smith Warrick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20140115000960 IN Practitioner - Physician Assistant 9830327022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greene County Health IncGroup PAC ID 7214226844, 8 clinicians

Practice addresses (Care Compare)

1600 A St NE
Suite 9
Linton, IN 47441-1612
Phone (812) 847-7005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10001546INMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greene County Health, Inc Past Accepting new patients
Greene County General Hospital LLC Physician Assistant Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1104267806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 A ST NE STE 9",
            "city": "LINTON",
            "state": "IN",
            "postal_code": "474411612",
            "telephone_number": "812-847-7005",
            "fax_number": "812-847-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 A ST NE STE 9",
            "city": "LINTON",
            "state": "IN",
            "postal_code": "47441",
            "telephone_number": "812-699-4153",
            "fax_number": "812-699-4271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 E Main St",
            "address_purpose": "LOCATION",
            "city": "Jasonville",
            "state": "IN",
            "postal_code": "474381510",
            "country_code": "US",
            "telephone_number": "812-665-9000",
            "fax_number": "812-665-9009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERKOLK",
        "first_name": "CORIANNE",
        "middle_name": "WARRICK",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORRIANNE",
            "last_name": "WARRICK",
            "middle_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Linton, IN

Sources for this page

Verify at the official NPI Registry.