Individual provider Active NPI

Thomas Jacob Corson

  • General Practice Physician
  • Loveland, CO
National Provider Identifier
1265624811
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
047701 Issued in CT
Practice address
2000 Boise Ave
Loveland, CO 80538-5006
Phone
(970) 635-4071
Fax
(970) 635-4177
NPI assigned
Aug 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 047701 CT
Emergency Medicine Physician 207P00000X 48063 CO
General Practice Physician 208D00000X 48063 CO
General Practice Physician 208D00000X 047701 CT Primary

Addresses

Primary practice location

2000 Boise Ave
Loveland, CO 80538-5006

Mailing address

PO Box 173817
Denver, CO 80217-3817
Phone (303) 306-7783

Other identifiers 2

IdentifierTypeStateIssuer
021193OtherCOKAISER COMMERCIAL NUMBER
86452550MedicaidCO

Other names 1

  • Dr. Thomas Jacob Corson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110215001197 CO Practitioner - Emergency Medicine 3476607896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

9330 S University Blvd
Suite 100
Highlands Ranch, CO 80126-5049
Phone (303) 346-3627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
48063COMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince Nov 20, 2017 Accepting new patients
American Current Care PA CurrentSince Nov 20, 2017 Accepting new patients

Locations

11877 E Arapahoe Rd
Ste 100
Centennial, CO 80112
Phone (303) 792-7368

1730 Blake St
Ste 100
Denver, CO 80202
Phone (303) 296-2273

200 W Belleview Ave
Unit 170
Englewood, CO 80110
Phone (303) 798-1009

9330 S University Blvd
Ste 100
Highlands Ranch, CO 80126
Phone (303) 346-3627

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1265624811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173817",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173817",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 BOISE AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805385006",
            "telephone_number": "970-635-4071",
            "fax_number": "970-635-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSON",
        "first_name": "THOMAS",
        "middle_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "047701",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "48063",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "48063",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CT",
            "license": "047701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "021193",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86452550",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "CORSON",
            "middle_name": "JACOB",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.