Active NPI
Andrew B McCorison, PA-C
- Physician Assistant
- Elizabethtown, NC
National Provider Identifier
1356448393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 101095
- Practice address
- 501 S Poplar St
Elizabethtown, NC 28337-9375 - Phone
- (910) 862-5100
- Fax
- (910) 862-1238
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 101095 | NC | Primary |
Addresses
Primary practice location
501 S Poplar St
Elizabethtown, NC 28337-9375
Mailing address
33 Union St
Ocean Isle Beach, NC 28469-7623
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101095 | Other | NC | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1356448393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 UNION ST",
"city": "OCEAN ISLE BEACH",
"state": "NC",
"postal_code": "284697623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S POPLAR ST",
"city": "ELIZABETHTOWN",
"state": "NC",
"postal_code": "283379375",
"telephone_number": "910-862-5100",
"fax_number": "910-862-1238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORISON",
"first_name": "ANDREW",
"middle_name": "B",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "101095",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "101095",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.