Active NPI
Robert Michael Corcoran, O.D.
- Optometrist
- Fort Gregg Adams, VA
National Provider Identifier
1467426973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG00639
- Practice address
- 700 24TH St
Fort Gregg Adams, VA 23801-1716 - Phone
- (804) 734-9253
- Fax
- (804) 734-9248
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG00639 | PA | Primary |
Addresses
Primary practice location
700 24TH St
Fort Gregg Adams, VA 23801-1716
Mailing address
3736 Conduit Rd
Colonial Heights, VA 23834-2630
Phone (570) 472-1924
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG00639 | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosebud Indian Health Service | Past | Accepting new patients | |
| DRC-Doctorsee | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1467426973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3736 CONDUIT RD",
"city": "COLONIAL HEIGHTS",
"state": "VA",
"postal_code": "238342630",
"telephone_number": "570-472-1924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 24TH ST",
"city": "FORT GREGG ADAMS",
"state": "VA",
"postal_code": "238011716",
"telephone_number": "804-734-9253",
"fax_number": "804-734-9248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORCORAN",
"first_name": "ROBERT",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG00639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Gregg Adams, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.