John W. Coryell, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F10190098 Issued in IN

Practice address

102 Hospital Dr
Chatsworth, GA 30705-2058

Phone

(706) 695-8313

NPI assigned

Jan 21, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Infinite Medical PC

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1407483175

  GA

  Medicare reassignment NPD
• Shifa Clinic, P.C.

  • Specialist
  • Valparaiso, IN
  • NPI 1639107790
  Medicare reassignment NPD

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1417587221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HOSPITAL DR",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052058",
            "telephone_number": "706-695-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HOSPITAL DR",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052058",
            "telephone_number": "706-695-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORYELL",
        "first_name": "JOHN",
        "middle_name": "W.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-21",
        "last_updated": "2021-07-22",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F10190098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alakhanimd@direct.practicefusion.com",
            "affiliation": "N",
            "address_1": "2701 Leonard Dr",
            "city": "Valparaiso",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463837121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Judith Ann Cook, APRN
• Robert Ted Cook, MD MPH FAAFP
• Corner Drugs Inc
• Corner Drugs Inc
• Corner Medical Center, Inc
• Lisa Counsell, M.D.
• Cplace Chatsworth SNF LLC
• Tommy Curtis, NP
• Connie Lynn Davenport
• Steven Deverell, PHARMD

• Family Nurse Practitioner in Chatsworth, GA
• Providers in Chatsworth, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.