Randol Arias Corporan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306606124 Issued in VA

Practice address

600 Gresham Dr
Norfolk, VA 23507-1904

Phone

(757) 388-3000

NPI assigned

Sep 11, 2024

Sex

Male

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

• Randol A Corporan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1225864895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5103 REGATTA POINTE RD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353525",
            "telephone_number": "843-271-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "984B Laskin Rd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234513905",
            "country_code": "US",
            "telephone_number": "757-395-6900",
            "fax_number": "833-628-5148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORPORAN",
        "first_name": "RANDOL",
        "middle_name": "ARIAS",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306606124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDOL",
            "last_name": "CORPORAN",
            "middle_name": "A",
            "credential": "PTA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer L. Copare, D.O.
• Adelaide Louisa Cope
• Adrienne Coqueran, MD
• Allyson Lyn Corey, CRNA
• Brittany Cornine
• Corpus Chrisi Health Supplies
• Janice Marie Corredor Keener, PSY.D.
• Marisa Corsale
• Christian Cort, MD
• Ricardo Cortes, MD

• All providers in Norfolk, VA
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.