Individual provider Active NPI

Corinne A Rathnam, PA-C

  • Family Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1346574753
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9104800 Issued in FL
Practice address
4623 Forest Hill Blvd
Suite 105
West Palm Beach, FL 33415-7469
Phone
(561) 969-7900
Fax
(561) 969-7919
NPI assigned
Oct 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9104800 FL Primary
Internal Medicine Physician 207R00000X 9104800 FL

Addresses

Primary practice location

4623 Forest Hill Blvd
Suite 105
West Palm Beach, FL 33415-7469

Mailing address

4623 Forest Hill Blvd
Suite 105
West Palm Beach, FL 33415-7469
Phone (561) 969-7900

Other identifiers 1

IdentifierTypeStateIssuer
9104800OtherFLSTATE LICENSE NUMBER

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

State licenses

LicenseStateTypeSpecialty
9104800FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Palm Beach Physicians & Urgent Care Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1346574753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 FOREST HILL BLVD",
            "address_2": "SUITE 105",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334157469",
            "telephone_number": "561-969-7900",
            "fax_number": "561-969-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4623 FOREST HILL BLVD",
            "address_2": "SUITE 105",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334157469",
            "telephone_number": "561-969-7900",
            "fax_number": "561-969-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHNAM",
        "first_name": "CORINNE",
        "middle_name": "A",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-01",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "9104800",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "9104800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "9104800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.