NPIMap

Individual provider Active NPI

Latosha Larkin Corley

  • Gerontology Nurse Practitioner
  • Orangeburg, SC
National Provider Identifier
1376193383
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
22980 Issued in SC
Practice address
3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone
(803) 395-2200
NPI assigned
Sep 12, 2019
Last updated
Sep 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X 22980 SC Primary

Addresses

Primary practice location

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442

Mailing address

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone (803) 395-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20200124001852 SC Practitioner - Nurse Practitioner 7911332796 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

1097 Cook Rd
Orangeburg, SC 29118-8209
Phone (803) 395-3370

111 John Lawson Ave
Santee, SC 29142-8654
Phone (803) 395-2070

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edisto Regional Health Services Inc. Multi-Specialty CurrentSince Nov 17, 2019 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Multi-Specialty CurrentSince Nov 17, 2019 Accepting new patients
The Regional Medical Center of Orangeburg and Calhoun Counties Multi-Specialty Current Accepting new patients
Musc Community Physicians CurrentSince Mar 1, 2023 Accepting new patients
Edisto Regional Health Services Inc. Multi-Specialty Current Accepting new patients
The Regional Medical Center of Orangeburg and Calhoun Counties Multi-Specialty CurrentSince Jan 15, 2020 Accepting new patients
The Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Nov 17, 2019 Accepting new patients
Musc Community Physicians Multi-Specialty Current Accepting new patients
Edisto Regional Health Services Inc CurrentSince Nov 17, 2019 Accepting new patients
Musc Community Physicians Multi-Specialty CurrentSince Mar 1, 2023 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

498 North St
Bamberg, SC 29003
Phone (803) 245-5144

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

187 Bunch Ford Rd
Holly Hill, SC 29059
Phone (803) 395-3068

1097B Cook Rd
Orangeburg, SC 29118
Phone (803) 534-5110

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

111 John Lawson Ave
Santee, SC 29142
Phone (781) 280-1577

Organizations & group practices 11

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1376193383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181442",
            "telephone_number": "803-395-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181442",
            "telephone_number": "803-395-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "LATOSHA",
        "middle_name": "LARKIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "22980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.