Mary Aneta Corley, RN, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP107303 Issued in TX

Practice address

123 N Main St
Lone Star, TX 75668-2223

Phone

(903) 656-0633

Fax

(903) 656-0636

NPI assigned

Jul 26, 2006

Last updated

May 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phynet, Inc.

  • Family Medicine Physician
  • Longview, TX
  • NPI 1144245176
  Medicare reassignment NPD
• Phynet, Inc.

  dba Hugman-Kent Clinic

  • Health Service Clinic/Center
  • Gladewater, TX
  • NPI 1912174111
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1326062316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 TECHNOLOGY CTR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052697",
            "telephone_number": "903-247-0484",
            "fax_number": "903-247-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N MAIN ST",
            "city": "LONE STAR",
            "state": "TX",
            "postal_code": "756682223",
            "telephone_number": "903-656-0633",
            "fax_number": "903-656-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "MARY",
        "middle_name": "ANETA",
        "credential": "RN, CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "437214",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP107303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092119904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eddie's Reaching Out Residential Corporation
• Froggies Helping Hands (Froggies Reaching Out Residential Services)
• Carla Gleaton, P.T.
• Tara Gray, FNP
• Helping Hands of East Texas Home Healthcare

• Family Nurse Practitioner in Lone Star, TX
• Providers in Lone Star, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.