Active NPI
Shannon Kathleen Corcoran, PA-C
- Surgical Physician Assistant
- Westerville, OH
National Provider Identifier
1326276379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 50.003075
- Practice address
- 955 Eastwind Dr
Westerville, OH 43081-3376 - Phone
- (888) 444-1203
- Fax
- (614) 268-7849
- NPI assigned
- Jun 29, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Surgical Physician Assistant | 363AS0400X | 50.003075 | OH | Primary |
Addresses
Primary practice location
955 Eastwind Dr
Westerville, OH 43081-3376
Mailing address
955 Eastwind Dr
Westerville, OH 43081-3376
Phone (614) 268-9561
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00900285 | Other | RR MEDICARE |
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371600000000",
"number": "1326276379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 EASTWIND DR",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430813376",
"telephone_number": "614-268-9561",
"fax_number": "614-268-7849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "955 EASTWIND DR",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430813376",
"telephone_number": "888-444-1203",
"fax_number": "614-268-7849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORCORAN",
"first_name": "SHANNON",
"middle_name": "KATHLEEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-29",
"last_updated": "2013-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "OH",
"license": "50.003075",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00900285",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Westerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.