NPIMap

Individual provider Active NPI

Cori Runfalo Sumrall, D.O.

  • Family Medicine Physician
  • Bogalusa, LA
National Provider Identifier
1336672823
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
311115 Issued in LA
Practice address
1616 S Columbia St Ste C
Bogalusa, LA 70427-5881
Phone
(985) 730-6970
Fax
(985) 545-1036
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 311115 LA Primary

Addresses

Primary practice location

1616 S Columbia St Ste C
Bogalusa, LA 70427-5881

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-5727

Other practice location 1

420 Avenue F
Bogalusa, LA 70427-3634
Phone (985) 735-6735

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address crunfalo951885@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190716001424 LA Practitioner - Family Practice 7416222534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
William Carey University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

433 Plaza St
Bogalusa, LA 70427-3729
Phone (985) 730-6706

617 Ave F
Bogalusa, LA 70427-3637
Phone (985) 730-6706

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Rapid Urgent Care, Inc. CurrentSince Jun 25, 2019 Accepting new patients
Wash-St Tammany Reg Medical Center Current Accepting new patients
Rapid Urgent Care, Inc. Current Accepting new patients
Rapid Urgent Care, Inc CurrentSince Jun 25, 2019 Accepting new patients
Rapid Urgent Care, Inc Current Accepting new patients
Washington St. Tammany Regional Medical Center Past Accepting new patients

Locations

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

1111 N Causeway Blvd
Mandeville, LA 70471
Phone (985) 249-5600

Interoperability endpoints

  • Direct secure messaging: crunfalo951885@direct.casso.us.com

Organizations & group practices 7

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1336672823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5727",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 S COLUMBIA ST STE C",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704275881",
            "telephone_number": "985-730-6970",
            "fax_number": "985-545-1036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Avenue F",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273634",
            "country_code": "US",
            "telephone_number": "985-735-6735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMRALL",
        "first_name": "CORI",
        "middle_name": "RUNFALO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "311115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crunfalo951885@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "crunfalo951885@direct.casso.us.com",
            "address_1": "1616 S Columbia St Ste C",
            "city": "Bogalusa",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704275881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1616 S Columbia St Ste C",
            "city": "Bogalusa",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704275881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bogalusa, LA

Sources for this page

Verify at the official NPI Registry.