Active NPI
Rachel Reising Corbin
- Primary Care Nurse Practitioner
- Rome, NY
National Provider Identifier
1164879722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- F340728-1
- Practice address
- 205 W Dominick St
Rome, NY 13440-5811 - Phone
- (315) 624-9470
- NPI assigned
- May 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | F340728-1 | NY | Primary |
Addresses
Primary practice location
205 W Dominick St
Rome, NY 13440-5811
Mailing address
205 West Dominick
Rome, NY 13440
Other practice location 1
13 Card Ave
Camden, NY 13316-1207
Phone (315) 335-7681
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164879722 | Medicaid | NY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F340728-1 | NY | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upstate Family Health Center Incorporated | 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 and National Provider Directory roles.
-
- Clinic/Center
- Utica, NY
- NPI 1093160012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1164879722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 WEST DOMINICK",
"city": "ROME",
"state": "NY",
"postal_code": "13440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 W DOMINICK ST",
"city": "ROME",
"state": "NY",
"postal_code": "134405811",
"telephone_number": "315-624-9470"
}
],
"practiceLocations": [
{
"address_1": "13 Card Ave",
"address_purpose": "LOCATION",
"city": "Camden",
"state": "NY",
"postal_code": "133161207",
"country_code": "US",
"telephone_number": "315-335-7681",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CORBIN",
"first_name": "RACHEL",
"middle_name": "REISING",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-24",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "NY",
"license": "F340728-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1164879722",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rome, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.