Individual provider Active NPI

Corey Michael Carson, M.D.

  • Family Medicine Physician
  • Marietta, GA
National Provider Identifier
1245599778
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
98617 Issued in GA
Practice address
660 Cherokee St NE Ste 100
Marietta, GA 30060-8930
Phone
(678) 797-8201
NPI assigned
May 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 98617 GA
Family Medicine Physician 207Q00000X 98617 GA Primary

Addresses

Primary practice location

660 Cherokee St NE Ste 100
Marietta, GA 30060-8930

Mailing address

660 Cherokee St NE
Marietta, GA 30060-8965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151210001270 CA Practitioner - Family PracticePractitioner - Sports Medicine 9133442528 Reassigns benefits to 2 organizations
I20240301003206 GA Practitioner - Sports Medicine 9133442528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Eastern Virginia Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

660 Cherokee St NE
Suite 100
Marietta, GA 30060-8930
Phone (678) 797-8210

Hospital & facility affiliations

  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
98617GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Mar 2, 2016 Accepting new patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Feb 27, 2024 Accepting new patients
Regents of the University of California Family Medicine CurrentSince Sep 26, 2015 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Mar 2, 2016 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Regents of the University of California CurrentSince Sep 26, 2015 Accepting new patients
Piedmont Providers LLC Past Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

3544 30th St
San Diego, CA 92104
Phone (619) 515-2424

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

660 Cherokee St NE
Ste 100
Marietta, GA 30060
Phone (678) 797-8201

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1245599778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 CHEROKEE ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 CHEROKEE ST NE STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608930",
            "telephone_number": "678-797-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "COREY",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "98617",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "98617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.