Individual provider Active NPI

Pamela Sue Corson, LPN

  • Licensed Practical Nurse
  • Kannapolis, NC
National Provider Identifier
1295950236
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
046556 Issued in NC
Practice address
1309 S Cannon Blvd
Kannapolis, NC 28083-6232
Phone
(704) 933-3212
Fax
(704) 933-3221
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 046556 NC Primary

Addresses

Primary practice location

1309 S Cannon Blvd
Kannapolis, NC 28083-6232

Mailing address

193 Madison Ave NE
Concord, NC 28025-3221
Phone (704) 723-6597

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
046556NCMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295950236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 MADISON AVE NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253221",
            "telephone_number": "704-723-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 S CANNON BLVD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836232",
            "telephone_number": "704-933-3212",
            "fax_number": "704-933-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSON",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "046556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.