Carol Dalire Corpuz

Key facts

NPI

1114247277

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

12675 (OH)

Practice address

624 Avon PL
Napoleon, OH 43545-1721

Phone

(410) 736-1049

NPI assigned

Jun 10, 2010

Sex

Female

Sole proprietor

No

Organizations & group practices 5

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.

• Kent Physical Therapy, LLC Physical Therapist · Dover, DE · NPI 1598224503
  Medicare reassignment Care Compare group NPD DE · PHYSICAL THERAPIST
• Ati Holdings, LLC Physical Therapy Clinic/Center · Rising Sun, MD · NPI 1396781050
  Medicare reassignment NPD DE · PHYSICAL THERAPIST
• Dynamic Therapy Services LLC Physical Therapist · Seaford, DE · NPI 1205875093
  Medicare reassignment NPD DE · PHYSICAL THERAPIST
• Ati Holdings, LLC Durable Medical Equipment & Medical Supplies · King of Prussia, PA · NPI 1750194460
  NPD PHYSICAL THERAPIST
• Dynamic Therapy Services, LLC Occupational Therapist · Rehoboth Beach, DE · NPI 1225637051
  NPD PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kent Physical Therapy, LLC (4 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in DE

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Mrs. Carol Paat Dalire Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 19, 2020.

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1114247277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 AVON PL",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435451721",
            "telephone_number": "410-736-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORPUZ",
        "first_name": "CAROL",
        "middle_name": "DALIRE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "12675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "DALIRE",
            "middle_name": "PAAT",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Napoleon, OH · Physical Therapist in Ohio