Active NPI
Adel B Korkor, MD
- Nephrology Physician
- Waukesha, WI
National Provider Identifier
1275568560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 24194-020
- Practice address
- 1111 Delafield St Ste 327
Waukesha, WI 53188-3407 - Phone
- (262) 524-1024
- Fax
- (262) 524-8767
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 24194-020 | WI | Primary |
Addresses
Primary practice location
1111 Delafield St Ste 327
Waukesha, WI 53188-3407
Mailing address
1111 Delafield St
Waukesha, WI 53188-3417
Phone (262) 524-1024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30401000 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24194-020 | WI | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group 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.
-
- Family Medicine Physician
- Waukesha, WI
- NPI 1790720613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501632000000",
"number": "1275568560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 DELAFIELD ST",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531883417",
"telephone_number": "262-524-1024",
"fax_number": "262-524-8767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 DELAFIELD ST STE 327",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531883407",
"telephone_number": "262-524-1024",
"fax_number": "262-524-8767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORKOR",
"first_name": "ADEL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2017-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "WI",
"license": "24194-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30401000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.