Individual provider Active NPI

Erin Corridon, M.D.

  • Family Medicine Physician
  • Miramar, FL
National Provider Identifier
1407953383
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
209782-1 Issued in NY
Practice address
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Phone
(954) 399-4642
Fax
(877) 859-8768
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 209782 NY
Family Medicine Physician 207Q00000X 209782-1 NY Primary

Addresses

Primary practice location

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308

Mailing address

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Phone (954) 399-4642

Other identifiers 1

IdentifierTypeStateIssuer
01867349MedicaidNY

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
209782-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bladen Medical Associates Family Medicine Past Accepting new patients

Organizations & group practices 1

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.

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": "1309996800000",
    "number": "1407953383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "954-399-4642",
            "fax_number": "877-859-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "954-399-4642",
            "fax_number": "877-859-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRIDON",
        "first_name": "ERIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "209782",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "209782-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01867349",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.