Individual provider Active NPI

Natalie A Corley, DMD

  • Dentist
  • Decatur, IL
National Provider Identifier
1184888539
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027487 Issued in IL
Practice address
160 W McKinley Ave
Decatur, IL 62526-3223
Phone
(217) 330-6217
Fax
(217) 330-8079
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019027487 IL Primary

Addresses

Primary practice location

160 W McKinley Ave
Decatur, IL 62526-3223

Mailing address

160 W McKinley Ave
Decatur, IL 62526-3223
Phone (217) 330-6217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150603002284 IL Order and Referring Only - DentistPractitioner - Dentist 9638490519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1184888539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 W MCKINLEY AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263223",
            "telephone_number": "217-330-6217",
            "fax_number": "217-330-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W MCKINLEY AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263223",
            "telephone_number": "217-330-6217",
            "fax_number": "217-330-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "NATALIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.