Individual provider Active NPI

Lauren Marie Correa, PA-C

  • Physician Assistant
  • Gastonia, NC
National Provider Identifier
1245874494
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11255 Issued in NC
Practice address
2555 Court Dr Ste 450
Gastonia, NC 28054-2191
Phone
(704) 671-7652
NPI assigned
Oct 31, 2019
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-11255 NC Primary

Addresses

Primary practice location

2555 Court Dr Ste 450
Gastonia, NC 28054-2191

Mailing address

PO Box 744786
Atlanta, GA 30374-4786

Other practice location 1

9200 Harris Corners Pkwy Ste K
Charlotte, NC 28269-3782
Phone (704) 342-9011

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210914002843 NC Practitioner - Physician Assistant 6305242405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-11255NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group, Inc. CurrentSince Feb 20, 2024 Accepting new patients
Caromont Medical Group Inc CurrentSince Feb 20, 2024 Accepting new patients

Locations

2555 Court Dr
Ste 450
Gastonia, NC 28054
Phone (704) 671-7652

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

Organizations & group practices 3

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.

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": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1245874494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR STE 450",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542191",
            "telephone_number": "704-671-7652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 Harris Corners Pkwy Ste K",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282693782",
            "country_code": "US",
            "telephone_number": "704-342-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORREA",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-31",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.