Individual provider Active NPI

Corina Anette Mark, PA

  • Physician Assistant
  • Fergus Falls, MN
National Provider Identifier
1386329159
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone
(218) 739-6870
Fax
(218) 739-6654
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X MN Primary

Addresses

Primary practice location

111 W Vernon Ave
Fergus Falls, MN 56537-2741

Mailing address

111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone (218) 739-6870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250409002427 MN Practitioner - Physician Assistant 7416471610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Ridge Hospital and Health ServicesGroup PAC ID 0648222349, 90 clinicians

Practice addresses (Care Compare)

649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (218) 736-8000

Hospital & facility affiliations

  • Prairie Ridge Hospital and Health Services Hospital, Elbow Lake, MN, CCN 241379
  • Lake Region Healthcare Corporation Hospital, Fergus Falls, MN, CCN 240052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation Multi-Specialty CurrentSince Jun 1, 2025 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jun 1, 2025 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jun 1, 2025 Accepting new patients

Locations

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

111 W Vernon Ave
Fergus Falls, MN 56537
Phone (218) 736-5770

712 S Cascade St
Fergus Falls, MN 56537

Organizations & group practices 3

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 2

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1386329159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372741",
            "telephone_number": "218-739-6870",
            "fax_number": "218-739-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372741",
            "telephone_number": "218-739-6870",
            "fax_number": "218-739-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "CORINA",
        "middle_name": "ANETTE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.