Individual provider Active NPI

Phyllis Correia, CNM

  • Advanced Practice Midwife
  • Fall River, MA
National Provider Identifier
1164576930
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
138498 Issued in MA
Practice address
1151 Robeson St Ste 201
Fall River, MA 02720-5566
Phone
(508) 730-1666
Fax
(508) 646-7119
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 138498 MA Primary

Addresses

Primary practice location

1151 Robeson St Ste 201
Fall River, MA 02720-5566

Mailing address

1151 Robeson St Ste 201
Fall River, MA 02720-5566
Phone (508) 730-1666

Other practice location 1

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 679-3131

Other identifiers 1

IdentifierTypeStateIssuer
0708887MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcorreia5675@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070410000447 MA Practitioner - Certified Nurse Midwife (CNM) 4981619624 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
138498MAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. Current Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Mar 31, 2014 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Mar 31, 2014 Accepting new patients
Obstetrics Gynecology and Midwifery of Newport PastSince Aug 1, 2014 Accepting new patients

Locations

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

1151 Robeson St
Ste 201
Fall River, MA 02720
Phone (508) 730-1666

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

1030 President Ave
Fall River, MA 02720
Phone (508) 235-6427

1151 Robeson St
Fl 2
Fall River, MA 02720
Phone (508) 646-6767

1565 N Main St
Ste 506
Fall River, MA 02720
Phone (508) 730-1666

Interoperability endpoints

  • Direct secure messaging: pcorreia5675@direct.southcoast.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1164576930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 ROBESON ST STE 201",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205566",
            "telephone_number": "508-730-1666",
            "fax_number": "508-646-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 ROBESON ST STE 201",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205566",
            "telephone_number": "508-730-1666",
            "fax_number": "508-646-7119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "363 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027203703",
            "country_code": "US",
            "telephone_number": "508-679-3131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORREIA",
        "first_name": "PHYLLIS",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "138498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0708887",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcorreia5675@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "363 Highland Ave",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027203703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.