Active NPI
Kimberly Anne Legg-Corba, DO
- Family Medicine Physician
- Allentown, PA
National Provider Identifier
1275504557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS 008453 L
- Practice address
- 1150 Glenlivet Dr
Ste A17
Allentown, PA 18106 - Phone
- (610) 530-9155
- Fax
- (610) 530-4495
- NPI assigned
- Jan 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS 008453 L | PA | Primary |
Addresses
Primary practice location
1150 Glenlivet Dr
Ste A17
Allentown, PA 18106
Mailing address
1150 Glenlivet Dr
Ste A17
Allentown, PA 18106
Phone (610) 530-9155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080195420 | Other | PALMETTO GBA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS 008453 L | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fornance Physician Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1275504557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 GLENLIVET DR",
"address_2": "STE A17",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "18106",
"telephone_number": "610-530-9155",
"fax_number": "610-530-4495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 GLENLIVET DR",
"address_2": "STE A17",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "18106",
"telephone_number": "610-530-9155",
"fax_number": "610-530-4495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGG-CORBA",
"first_name": "KIMBERLY",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-27",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "OS 008453 L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA",
"identifier": "080195420",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.