Active NPI
Rebecca Korman
- Physician Assistant
- Winter Park, FL
National Provider Identifier
1477952083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9108002
- Practice address
- 133 Benmore Dr
Suite 100
Winter Park, FL 32792-4111 - Phone
- (407) 644-4883
- Fax
- (407) 644-3697
- NPI assigned
- Aug 19, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9108002 | FL | Primary |
Addresses
Primary practice location
133 Benmore Dr
Suite 100
Winter Park, FL 32792-4111
Mailing address
133 Benmore Dr
Suite 100
Winter Park, FL 32792-4111
Phone (407) 644-4883
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| O14323300 | Medicaid | FL |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9108002 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452470400000",
"number": "1477952083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 BENMORE DR",
"address_2": "SUITE 100",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924111",
"telephone_number": "407-644-4883",
"fax_number": "407-644-3697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 BENMORE DR",
"address_2": "SUITE 100",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924111",
"telephone_number": "407-644-4883",
"fax_number": "407-644-3697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORMAN",
"first_name": "REBECCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-19",
"last_updated": "2016-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9108002",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "O14323300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.