Individual provider Active NPI

Corrine A Favela, N.P.

  • Nurse Practitioner
  • Downey, CA
National Provider Identifier
1447304001
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP15844 Issued in CA
Practice address
11525 Brookshire Ave Ste 301
Attn Maggie Noles Ms 6160
Downey, CA 90241-4982
Phone
(562) 862-3684
Fax
(562) 862-7145
NPI assigned
Jan 22, 2007
Last updated
Oct 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP15844 CA Primary
Nurse Practitioner 363L00000X RN570209 CA

Addresses

Primary practice location

11525 Brookshire Ave Ste 301
Attn Maggie Noles Ms 6160
Downey, CA 90241-4982

Mailing address

9209 Colima Rd
Ste 1000
Whittier, CA 90605-1813
Phone (562) 696-1104

Other names 1

  • Corrine A. Porras Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, VA, NC, TN4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20241008003840 NV Practitioner - Nurse Practitioner 3971881889 Reassigns benefits to 1 organization
I20241213000717 VA Practitioner - Nurse Practitioner 3971881889
I20250129003046 NC Practitioner - Nurse Practitioner 3971881889 Reassigns benefits to 1 organization
I20250224002428 TN Practitioner - Nurse Practitioner 3971881889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albion Medical Group of Nevada, PCGroup PAC ID 4183891294, 23 clinicians

Practice addresses (Care Compare)

100 N Green Vallety Pkwy
Suite 220
Henderson, NV 89074-6392
Phone (702) 944-3627

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15844CAMDChiropractor
NP15844CAMDNurse Practitioner
RN570209CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Group of Nevada, PC CurrentSince Sep 1, 2024 Accepting new patients
Carelon Medical Partners of North Carolina PC CurrentSince Nov 8, 2024 Accepting new patients
Caremore Medical Group of North Carolina, PC CurrentSince Nov 8, 2024 Accepting new patients
Physicians Medical Center Kaufman, LTD PastSince Sep 1, 2024 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

1100 N Raleigh Blvd
Ste 130
Raleigh, NC 27610
Phone (919) 838-2887

100 N Green Valley Pkwy
Ste 220
Henderson, NV 89074
Phone (702) 944-3627

3041 E Flamingo Rd
Ste A
Las Vegas, NV 89121
Phone (702) 436-0835

Interoperability endpoints

  • Direct secure messaging: corrine.favela.1@32527.direct.athenahealth.com
  • Direct secure messaging: corrine.favela.p1@direct.caremorewest.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1447304001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9209 COLIMA RD",
            "address_2": "STE 1000",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051813",
            "telephone_number": "562-696-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 BROOKSHIRE AVE STE 301",
            "address_2": "ATTN MAGGIE NOLES MS 6160",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902414982",
            "telephone_number": "562-862-3684",
            "fax_number": "562-862-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVELA",
        "first_name": "CORRINE",
        "middle_name": "A",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP15844",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "RN570209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORRINE",
            "last_name": "PORRAS",
            "middle_name": "A.",
            "credential": "N.P.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.