Individual provider Active NPI

Cassie Deese Corbin, APRN

  • Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1427430586
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9179861 Issued in FL
Practice address
2617 Mitcham Dr Ste 102
Tallahassee, FL 32308-5479
Phone
(850) 878-1171
Fax
(850) 942-1291
NPI assigned
Jun 25, 2015
Last updated
Feb 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9179861 FL Primary

Addresses

Primary practice location

2617 Mitcham Dr Ste 102
Tallahassee, FL 32308-5479

Mailing address

2617 Mitcham Dr Ste 102
Tallahassee, FL 32308-5479
Phone (850) 878-1171

Other identifiers 2

IdentifierTypeStateIssuer
015819700MedicaidFL
060754100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20151015001097 FL Practitioner - Nurse Practitioner 9335458223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Nephrology AssociatesGroup PAC ID 9436242211, 9 clinicians

Practice addresses (Care Compare)

2617 Mitcham Dr
Suite 102
Tallahassee, FL 32308-5479
Phone (850) 878-1171

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9179861FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Nephrology Associates CurrentSince Jul 20, 2015 Accepting new patients

Locations

1609 Physicians Dr
Tallahassee, FL 32308
Phone (850) 431-4243

2617 Mitcham Dr
Ste 102
Tallahassee, FL 32308
Phone (850) 878-1171

Interoperability endpoints

  • Direct secure messaging: clinical@nfna.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72257

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1427430586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 MITCHAM DR STE 102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085479",
            "telephone_number": "850-878-1171",
            "fax_number": "850-942-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 MITCHAM DR STE 102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085479",
            "telephone_number": "850-878-1171",
            "fax_number": "850-942-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "CASSIE",
        "middle_name": "DEESE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9179861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015819700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060754100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.