Marcus Corkern, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6490 Issued in LA

Practice address

17029 N Lakeway Ave
Baton Rouge, LA 70810-8960

Phone

(225) 328-9361

NPI assigned

Jun 10, 2014

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

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1457764094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17029 N LAKEWAY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708108960",
            "telephone_number": "225-328-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17029 N LAKEWAY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708108960",
            "telephone_number": "225-328-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORKERN",
        "first_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Core Clinics, LLC
• Kacey Core
• Corey a. Robertson, a Professional Dental Corporation
• Corey a. Robertson, DDS a Professional Dental Corporation
• Corey Hall MD LLC
• Kashon Corley, LPC
• Madison Bryant Corley, PA
• Victoria Corley
• Devin Corlin
• Carli Whiteside Cormier, PT, DPT

• General Practice Dentistry in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.