Individual provider Active NPI

Todd James Corley, CNP

  • Adult Health Nurse Practitioner
  • Kimbolton, OH
National Provider Identifier
1134470214
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
13855-NP Issued in OH
Practice address
76576 Johnson Run Rd
Kimbolton, OH 43749-9535
Phone
(330) 802-2123
Fax
(740) 492-4305
NPI assigned
Sep 28, 2012
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 13855-NP OH Primary

Addresses

Primary practice location

76576 Johnson Run Rd
Kimbolton, OH 43749-9535

Mailing address

76576 Johnson Run Rd
Kimbolton, OH 43749-9535
Phone (330) 802-2123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20121227000361 OH Practitioner - Nurse Practitioner 0446403414 Practice locations: Kimbolton, OH

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Kimbolton, OH 43749
Phone (330) 802-2123

76576 Johnson Run Rd
Kimbolton, OH 43749-9535

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13855-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Nurse Practitioners, Inc. Past Accepting new patients

Organizations & group practices 1

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 2

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": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1134470214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76576 JOHNSON RUN RD",
            "city": "KIMBOLTON",
            "state": "OH",
            "postal_code": "437499535",
            "telephone_number": "330-802-2123",
            "fax_number": "740-492-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76576 JOHNSON RUN RD",
            "city": "KIMBOLTON",
            "state": "OH",
            "postal_code": "437499535",
            "telephone_number": "330-802-2123",
            "fax_number": "740-492-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "TODD",
        "middle_name": "JAMES",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-28",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "13855-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kimbolton, OH

Sources for this page

Verify at the official NPI Registry.