Corey Edward Greene, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

679 Issued in WV

Practice address

40 Shae Ave Ste a
Chapmanville, WV 25508-9805

Phone

(304) 310-2261

Fax

(304) 310-2262

NPI assigned

Jan 11, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV, KY2 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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hilltop Primary Care IncGroup PAC ID 8628969847, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Hilltop Primary Care, Inc

  • Rural Health Clinic/Center
  • Phelps, KY
  • NPI 1124084488
  Medicare reassignment Care Compare group
• Lincoln County Primary Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hamlin, WV
  • NPI 1942274543
  Medicare reassignment NPD
• Greene Skin and Wellness

  • Physician Assistant
  • Chapmanville, WV
  • NPI 1225817802
  Medicare reassignment
• Lincoln County Primary Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Logan, WV
  • NPI 1023331220
  NPD
• Lincoln County Primary Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Hamlin, WV
  • NPI 1962583054
  NPD
• Lincoln County Primary Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Man, WV
  • NPI 1689997678
  NPD
• Lincoln County Primary Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gilbert, WV
  • NPI 1942523931
  NPD
• Elm Emergency Group PLLC

  • Emergency Medicine Physician
  • Logan, WV
  • NPI 1447400734

  Medical

  NPD (past)

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1174828867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SHAE AVE STE A",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "255089805",
            "telephone_number": "304-310-2261",
            "fax_number": "304-310-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SHAE AVE STE A",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "255089805",
            "telephone_number": "304-310-2261",
            "fax_number": "304-310-2262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Prosperity Ln",
            "address_2": "Suite 207",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "WV",
            "postal_code": "256013743",
            "country_code": "US",
            "telephone_number": "304-752-8202",
            "fax_number": "304-752-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "COREY",
        "middle_name": "EDWARD",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-11",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "01532",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810020048",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174828867",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Diane George
• Summer Ghee
• Jacob Gibson
• Victoria Lynn Gore
• Greene Skin and Wellness
• Joyce Marie Gullett
• Laura Hamilton
• Brittney Hartman
• Tonya Hatfield
• Heartful Healing LLC

• Physician Assistant in Chapmanville, WV
• Providers in Chapmanville, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.