Juan Carlos Corvalan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

33077 Issued in MO

Practice address

1 Jefferson Barracks Rd
Vamc-St.Louis
Saint Louis, MO 63125-4181

Phone

(314) 894-6639

NPI assigned

May 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306883509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS RD",
            "address_2": "VAMC-ST. LOUIS",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-894-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS RD",
            "address_2": "VAMC-ST.LOUIS",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-894-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORVALAN",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "33077",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "90-26",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Michelle Corry, OTR/L
• Samuel Reynaldo Cortez Granados, MD
• Autumn Cortivo
• Gwendolyn Anne Cortopassi, CPNP-AC
• Jennifer M Cortopassi, PA-C
• Marcie E Corwin, OTA/LICENSED
• Blake Christian Cory, DNP, FNP-C
• Tammy Lynn Coryell, APRN-NC
• Maria Corzo
• Alison Jane Cosa, FNP-C

• Psychiatry Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychiatry Physician in Missouri

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.