Individual provider Active NPI

Corey Arthur Hollis, D.C.

  • Rehabilitation Chiropractor
  • Irvine, CA
National Provider Identifier
1295994101
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
28089 Issued in CA
Practice address
17911 Sky Park Cir
Suite L
Irvine, CA 92614-6322
Phone
(949) 502-5520
Fax
(949) 502-5593
NPI assigned
Jun 5, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 28089 CA Primary
Orthopedic Chiropractor 111NX0800X 28089 CA

Addresses

Primary practice location

17911 Sky Park Cir
Suite L
Irvine, CA 92614-6322

Mailing address

17911 Sky Park Cir
Suite L
Irvine, CA 92614-6322
Phone (949) 502-5520

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
28089CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Physica Inc. CurrentSince Jan 1, 2016 Accepting new patients
Oc Physicians Group Rehabilitation Past Accepting new patients

Locations

17911 Sky Park Cir
Ste L
Irvine, CA 92614
Phone (949) 502-5520

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1295994101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17911 SKY PARK CIR",
            "address_2": "SUITE L",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146322",
            "telephone_number": "949-502-5520",
            "fax_number": "949-502-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17911 SKY PARK CIR",
            "address_2": "SUITE L",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146322",
            "telephone_number": "949-502-5520",
            "fax_number": "949-502-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "COREY",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "28089",
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "28089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.