Individual provider Active NPI

Justin B Corbin, P.A.

  • Surgical Physician Assistant
  • Charlotte, NC
National Provider Identifier
1174807895
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-04272 Issued in NC
Practice address
225 Baldwin Ave
Charlotte, NC 28204-3109
Phone
(704) 376-1605
Fax
(704) 335-8448
NPI assigned
Sep 29, 2011
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-04272 NC
Surgical Physician Assistant 363AS0400X 0010-04272 NC Primary

Addresses

Primary practice location

225 Baldwin Ave
Charlotte, NC 28204-3109

Mailing address

225 Baldwin Ave
Charlotte, NC 28204-3109
Phone (704) 376-1605

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address justin.corbinpac.p1@direct.cnsa.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131014000300 NC Practitioner - Physician Assistant 3577739085 Reassigns benefits to 2 organizations
I20231011000586 SC Practitioner - Physician Assistant 3577739085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Carolina Neurosurgery and Spine Associates PAGroup PAC ID 7214833375, 104 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

225 Baldwin Ave
Charlotte, NC 28204-3109
Phone (704) 376-1605

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

937 Riverwalk Pkwy
Rock Hill, SC 29730-0178
Phone (803) 325-1618

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3832SCMDPhysical Therapy Assistant
0010-04272NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Health Neurospine Network LLC CurrentSince Oct 1, 2025 Accepting new patients
Carolina Neurosurgery & Spine Associates PA CurrentSince Apr 1, 2014 Accepting new patients
Carolina Neurosurgery & Spine Associates PA CurrentSince Apr 1, 2014 Accepting new patients
Atrium Health Neurospine Network LLC CurrentSince Oct 1, 2025 Accepting new patients
Carolina Neurosurgery, PA Past Accepting new patients
North Carolina Emergency Partners LLC Past Accepting new patients

Locations

225 Baldwin Ave
Charlotte, NC 28204
Phone (704) 376-1605

110 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 792-2672

937 Riverwalk Pkwy
Rock Hill, SC 29730
Phone (803) 325-1618

937 Riverwalk Pkwy
Ste 101
Rock Hill, SC 29730
Phone (800) 344-6716

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • FHIR API: https://epicproxy.et0905.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: jcorbin499498@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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 11

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": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1174807895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BALDWIN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043109",
            "telephone_number": "704-376-1605",
            "fax_number": "704-335-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BALDWIN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043109",
            "telephone_number": "704-376-1605",
            "fax_number": "704-335-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "JUSTIN",
        "middle_name": "B",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-29",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-04272",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-04272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin.corbinpac.p1@direct.cnsa.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "225 Baldwin Ave",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.