Carlos Mario Corella, RMA

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

190586 Issued in IA

Practice address

914 Deforest Ave
Iowa City, IA 52240-2140

Phone

(319) 621-3095

Fax

(844) 883-6979

NPI assigned

May 2, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carlos Mario Corella Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Medical Assistant

State licenses

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621728000000",
    "number": "1407439045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 DEFOREST AVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402140",
            "telephone_number": "319-621-3095",
            "fax_number": "844-883-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 DEFOREST AVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402140",
            "telephone_number": "319-621-3095",
            "fax_number": "844-883-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORELLA",
        "first_name": "CARLOS",
        "middle_name": "MARIO",
        "credential": "RMA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "IA",
            "license": "190586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLOS",
            "last_name": "CORELLA",
            "middle_name": "MARIO",
            "credential": "RMA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Phlebotomy Technician in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Phlebotomy Technician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2021; 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.