Carla Cork, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02003708A Issued in IN

Practice address

5555 N Tacoma Ave
Suite, 12
Indianapolis, IN 46220-3512

Phone

(317) 501-0210

Fax

(317) 236-6054

NPI assigned

Jul 27, 2007

Last updated

Jan 23, 2017By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Interoperability endpoints

• Direct secure messaging: carla.cork.1@12519.direct.athenahealth.com

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.

• Carrie B. Boyd Healthcare Center

  • Health Service Clinic/Center
  • Indianapolis, IN
  • NPI 1609323708
  Authorized official Same address or phone
• Advanced Healthcare Associates LLP

  • Geriatric Medicine (Internal Medicine) Physician
  • Elwood, IN
  • NPI 1841225091
  NPD (past)
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643
  NPD (past)

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1194915926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7140",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460387140",
            "telephone_number": "317-501-0210",
            "fax_number": "317-236-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N TACOMA AVE",
            "address_2": "SUITE, 12",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203512",
            "telephone_number": "317-501-0210",
            "fax_number": "317-236-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORK",
        "first_name": "CARLA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003708A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201178190",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terica Lynne Corey, CST
• Woodrow A Corey, MD
• Holly Snow Coriell, O.D.
• Corinthains Home Help Care LLC
• Corinthians Transportation Care Services LLC
• Aleah Corkins
• Tyler Todd Corless, PA
• Dexter James Corlett, MD
• Erikka Corley
• Kortney Corman

• Family Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.