Corbin Michael Allred, PA-C
Individual provider Active NPI Physician Assistant · Gresham, OR
NPI 1306256359 · NPPES record last updated Dec 3, 2015
Key facts
- NPI
- 1306256359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA174316 (OR)
- Practice address
- 2850 SE Powell Valley Rd
Gresham, OR 97080-1494 - Phone
- (503) 666-5050
- NPI assigned
- Apr 29, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000
Hospital & facility affiliations
- St. George Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200922001830 | UT | Practitioner - Physician Assistant | 2668773813 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| CM6, PLLC | Physician Assistant | Current | Accepting new patients |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA174316 | OR | Yes |
Addresses
Primary practice location
2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Mailing address
PO Box 3777
Portland, OR 97208-3777
Other providers in Gresham, OR
- Kathryn E Allen
- Ryan Allen
- Sara Christine Allender
- Carissa Alleva
- Jacob Luke Allison
- Karen Yessenia Alonso-Granados
- Alta Ulrich, LMT LLC
- Alternative Sleep Health, Inc
- Doug R Altilio
- Nicole Lavonne Altstadt
All providers in Gresham, OR · Physician Assistant in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.