Individual provider Active NPI

Corey L Nyhus, MD

  • Family Medicine Physician
  • Perham, MN
National Provider Identifier
1386661858
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45593 Issued in MN
Practice address
665 3Rd St SW
Perham, MN 56573-1108
Phone
(218) 347-1200
Fax
(218) 346-4043
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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 3921 ND
Family Medicine Physician 207Q00000X 45593 MN Primary

Addresses

Primary practice location

665 3Rd St SW
Perham, MN 56573-1108

Mailing address

665 3Rd St SW
Perham, MN 56573-1108
Phone (218) 347-1200

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45593MNMDFamily Medicine Physician
3921NDMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1386661858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 3RD ST SW",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565731108",
            "telephone_number": "218-347-1200",
            "fax_number": "218-346-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 3RD ST SW",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565731108",
            "telephone_number": "218-347-1200",
            "fax_number": "218-346-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYHUS",
        "first_name": "COREY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "3921",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "45593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perham, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.