Corey J McCann, CANP
Individual provider Active NPI Adult Health Nurse Practitioner · Lake Charles, LA
NPI 1477831196 · NPPES record last updated Sep 13, 2021
Key facts
- NPI
- 1477831196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- AP06636 (LA)
- Practice address
- 1717 Oak Park Blvd FL 3
Lake Charles, LA 70601-8990 - Phone
- (337) 494-4900
- NPI assigned
- Jul 29, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Center for Orthopaedics and Spine LLC
Practice addresses (Care Compare)
1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone (337) 721-7236
Hospital & facility affiliations
- Vitalcaring Group
- Beauregard Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120220000289 | LA | Practitioner - Nurse Practitioner | 9436317625 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Adult Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN114345 | LA | MD | Orthopedic Registered Nurse |
| AP06636 | LA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ochsner Clinic LLC | Single Specialty | Current | Accepting new patients |
| Ochsner Clinic LLC | Current |
Accepting new patients | |
| Ochsner Clinic LLC | Current |
Accepting new patients | |
| Center for Orthopaedics and Spine LLC | Single Specialty | Current |
Accepting new patients |
| Center for Orthopaedics and Spine LLC | Single Specialty | Current |
Accepting new patients |
Locations
1636 Elton Rd
Ste 201
Jennings, LA 70546
Phone (337) 721-7236
1717 Oak Park Blvd
Fl 3
Lake Charles, LA 70601
Phone (337) 494-4900
4150 Nelson Rd
Ste G
Lake Charles, LA 70605
Phone (337) 310-0440
1747 Imperial Blvd
Lake Charles, LA 70605
Phone (337) 721-7236
1514 Jefferson Hwy
New Orleans, LA 70121
104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner |
363LA2200X | AP06636 | LA | Yes |
| Orthopedic Registered Nurse | 163WX0800X | RN114345 | LA |
Addresses
Primary practice location
1717 Oak Park Blvd FL 3
Lake Charles, LA 70601-8990
Mailing address
1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone (337) 721-7236
Other providers in Lake Charles, LA
- Mason Douglas McCain
- Aaron McCall
- Kari S. McCall
- Raymond L McCall
- Thomas Howard McCalla
- Shatonia McCarty
- McCauley Vision, LLC
- Lindsey A McCauley
- Matthew McCauley
- Michael McCauley
All providers in Lake Charles, LA · Adult Health Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.