Individual provider Active NPI

Micki Sharpe Korn, CRNP

  • Family Nurse Practitioner
  • Foley, AL
National Provider Identifier
1124051693
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-050138 Issued in AL
Practice address
1090 East Laurel Avenue
Foley, AL 36535-2248
Phone
(251) 943-7901
Fax
(251) 943-1949
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-050138 AL Primary

Addresses

Primary practice location

1090 East Laurel Avenue
Foley, AL 36535-2248

Mailing address

1090 East Laurel Avenue
Foley, AL 36535-2248
Phone (251) 943-7901

Other identifiers 1

IdentifierTypeStateIssuer
891005690MedicaidAL

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Baldwin Pediatrics Family Past Accepting new patients
Gary a. Eberly, MD PC Past Accepting new patients
Dr Jean F Bolton MD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mickiraber@eberlymd.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1124051693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 EAST LAUREL AVENUE",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352248",
            "telephone_number": "251-943-7901",
            "fax_number": "251-943-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 EAST LAUREL AVENUE",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352248",
            "telephone_number": "251-943-7901",
            "fax_number": "251-943-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORN",
        "first_name": "MICKI",
        "middle_name": "SHARPE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-050138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891005690",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.