Fred Corder Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.000341 Issued in OH

Practice address

440 Browns LN
Coshocton, OH 43812-2044

Phone

(740) 622-0332

NPI assigned

Dec 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Prime Healthcare Foundation - Coshocton, LLC

  • General Acute Care Hospital
  • Coshocton, OH
  • NPI 1013468172
  Medicare reassignment NPD

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164586400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 SEVERN DR",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438122737",
            "telephone_number": "740-622-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 BROWNS LN",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438122044",
            "telephone_number": "740-622-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDER",
        "first_name": "FRED",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.000341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA-C LICENSE NUMBER",
            "identifier": "50.000341",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riley Conkle
• Carolyn Contonio, OTR/L
• Angela Copenhaver, MOT, OTR/L
• Steven Roy Copenhaver
• Renee Corbett
• Coshocton Anesthesia Assoc
• Coshocton Anesthesia Professionals LTD
• Coshocton Chiropractic Health Clinic
• Coshocton City Board of Education
• Coshocton County Board of MRDD

• Physician Assistant in Coshocton, OH
• Providers in Coshocton, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.