Natalia Corales
Individual provider Active NPI Physician Assistant · Clinton, MS
NPI 1114759792 · NPPES record last updated Aug 14, 2024
Key facts
- NPI
- 1114759792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 141 Lofty Pine LN
Clinton, MS 39056-6301 - Phone
- (901) 482-5115
- NPI assigned
- Aug 14, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250131001330 | MS | Practitioner - Physician Assistant | 4284163577 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
141 Lofty Pine LN
Clinton, MS 39056-6301
Mailing address
141 Lofty Pine LN
Clinton, MS 39056-6301
Phone (901) 482-5115
Other providers in Clinton, MS
- Lakesha Cole
- Tia Symone Coleman
- Dante Sebastian Collado
- Lauren Michelle Collins
- Copd Pharmacy Consultants LLC
- Emily Cork
- Kinsey Costello
- Kimberly Course
- Jessie M Coy
- Anita Craft
All providers in Clinton, MS · Physician Assistant in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.