Andrea Rose Corpus

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-10924 Issued in NC

Practice address

5501 Executive Center Dr Ste 215
Charlotte, NC 28212-8823

Phone

(980) 613-8312

NPI assigned

Aug 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Andrea Rose McKinney Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Soul Care, PLLCGroup PAC ID 8224329008, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Soul Care, PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1821320334
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1184236226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 GRAYLING CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282271200",
            "telephone_number": "423-360-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 EXECUTIVE CENTER DR STE 215",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128823",
            "telephone_number": "980-613-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORPUS",
        "first_name": "ANDREA",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "MCKINNEY",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lyncia Corona
• Corporate Health International (McLaughlin Young Group)
• Corporate Health International (McLaughlin Young Group)
• Corporate Health International (McLaughlin Young Employee Services)
• Corporate Health International Inc (McLaughlin Young Employee Services)
• Edwin Corral, MD
• Guilherme Louback Corral, DO
• Hannah Elizabeth Corral, MD
• Jimena S Correa Cortez
• Karen Priscilla Correa, RDN

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.