Kevin Scott Corum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4705 Issued in TN

Practice address

210 Simmons St
Maryville, TN 37801-4750

Phone

(865) 970-9800

Fax

(865) 983-4518

NPI assigned

Jul 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• New Path PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Knoxville, TN
  • NPI 1801524624
  NPD (past)
• Parkwest Medical Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Maryville, TN
  • NPI 1699757609
  NPD (past)
• Tennessee Vein Center, PLLC

  • Primary Care Clinic/Center
  • Alcoa, TN
  • NPI 1598070807
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1316945504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 BOB CARNES RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379241801",
            "telephone_number": "865-964-5882",
            "fax_number": "865-689-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SIMMONS ST",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014750",
            "telephone_number": "865-970-9800",
            "fax_number": "865-983-4518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2606 Greenway Dr",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379181904",
            "country_code": "US",
            "telephone_number": "865-964-5882",
            "fax_number": "865-689-4443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORUM",
        "first_name": "KEVIN",
        "middle_name": "SCOTT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q031992",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Tippy Copeland, CCC-SLP
• Andrea Coppenger, NP
• Julie Ann Elisabeth Corcoran, DO, FACS
• Candice B Cornett, CCC-SLP
• Kristi Clark Correll, MA CCC-SLP
• Jordan Daniel Costello
• Daniel W Cotten, MD
• Victoria Ann Coughlin
• Lisa Coulson, COTA/L
• Amanda Jo Coulter, AGPCNP

• All providers in Maryville, TN
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.