Active NPI
Laurie Anne Coryell, M.D.
- Emergency Medicine Physician
- Monument, CO
National Provider Identifier
1477641298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- CO26821
- Practice address
- 17230 Jackson Creek Pkwy
Ste 120
Monument, CO 80132-7301 - Phone
- (719) 571-7070
- Fax
- (719) 571-7079
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | CO26821 | CO | Primary |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | CO26821 | CO |
Addresses
Primary practice location
17230 Jackson Creek Pkwy
Ste 120
Monument, CO 80132-7301
Mailing address
17230 Jackson Creek Pkwy
Ste 120
Monument, CO 80132-7301
Phone (719) 571-7070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01268218 | Medicaid | CO |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO26821 | CO | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Community Health | Past | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Medical Specialty Clinic/Center
- Boulder, CO
- NPI 1407685498
-
- Adult Mental Health Clinic/Center
- Boulder, CO
- NPI 1568121622
-
- Multi-Specialty Clinic/Center
- Boulder, CO
- NPI 1609822030
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480464000000",
"number": "1477641298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17230 JACKSON CREEK PKWY",
"address_2": "STE 120",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801327301",
"telephone_number": "719-571-7070",
"fax_number": "719-571-7079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17230 JACKSON CREEK PKWY",
"address_2": "STE 120",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801327301",
"telephone_number": "719-571-7070",
"fax_number": "719-571-7079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORYELL",
"first_name": "LAURIE",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2016-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "CO26821",
"primary": true
},
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "CO",
"license": "CO26821",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01268218",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monument, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.