Individual provider Active NPI

Eddy Gene Corse, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Lufkin, TX
National Provider Identifier
1265893499
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2284 Issued in TX
Practice address
200 S John Redditt Dr
Lufkin, TX 75904-3112
Phone
(936) 632-5252
NPI assigned
Mar 16, 2016
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X 2284 TX Primary

Addresses

Primary practice location

200 S John Redditt Dr
Lufkin, TX 75904-3112

Mailing address

200 S John Redditt Dr
Lufkin, TX 75904-3112
Phone (936) 632-5252

Other practice location 1

1670 Clairmont Rd
Podiatry Dept
Decatur, GA 30033-4004
Phone (404) 321-6111 ext. 7254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170717003424 TX Practitioner - Podiatry 3577833045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Texas Foot AssociatesGroup PAC ID 3870670953, 7 clinicians
Angelina Wound Center, LLCGroup PAC ID 6709308752, 5 clinicians

Practice addresses (Care Compare)

101 Westside Medical Blvd
Lufkin, TX 75904-3207
Phone (936) 632-5252

200 S John Redditt Dr
Lufkin, TX 75904-3112
Phone (936) 632-5252

210 W Park
Suite 100
Livingston, TX 77351-8337
Phone (936) 632-5252

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue149
Removal of skin lesions1-10
Removal of nail tissue673
Removal or shaving of skin growth175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2284TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Foot Associates Foot & Ankle Surgery CurrentSince Aug 1, 2017 Accepting new patients
Angelina Wound Center, LLC CurrentSince Feb 9, 2025 Accepting new patients

Locations

210 W Park
Ste 100
Livingston, TX 77352
Phone (281) 501-5652

101 Westside Medical Blvd
Lufkin, TX 75904

200 S John Redditt Dr
Lufkin, TX 75904
Phone (409) 639-1110

Interoperability endpoints

  • Direct secure messaging: ecorse@etfa-tx.direct.office.nextgen.com

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, 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": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1265893499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043112",
            "telephone_number": "936-632-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043112",
            "telephone_number": "936-632-5252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 Clairmont Rd",
            "address_2": "Podiatry Dept",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300334004",
            "country_code": "US",
            "telephone_number": "404-321-6111 x7254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORSE",
        "first_name": "EDDY",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "2284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.