Individual provider Active NPI

Corey Carr, M.D.

  • Psychiatry Physician
  • Brookfield, WI
National Provider Identifier
1295952307
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
57243 Issued in WI
Practice address
13950 W Capitol Dr
2ND FL
Brookfield, WI 53005-2441
Phone
(414) 874-6288
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 57243 WI Primary

Addresses

Primary practice location

13950 W Capitol Dr
2ND FL
Brookfield, WI 53005-2441

Mailing address

400 W River Woods Pkwy
3Rd FL
Glendale, WI 53212-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191118001364 CA Practitioner - Psychiatry 9931295888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Iowa, RJ & L Carver College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

5321 Via Marisol
Los Angeles, CA 90042-4883
Phone (323) 478-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Aug 24, 2019 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Trustees of Columbia University in Department of Psychiatry Psychiatry Past Accepting new patients
Ascension SE Wisconsin Hospital, Inc Past Accepting new patients

Locations

11080 W Olympic Blvd
Fl 1
Los Angeles, CA 90064
Phone (310) 966-6610

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

5321 Via Marisol
Los Angeles, CA 90042
Phone (323) 474-6393

Organizations & group practices 4

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1295952307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W RIVER WOODS PKWY",
            "address_2": "3RD FL",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13950 W CAPITOL DR",
            "address_2": "2ND FL",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052441",
            "telephone_number": "414-874-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "COREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "57243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.