Individual provider Active NPI

Nicole Lynn Corey, NP

  • Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1508017393
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13772 Issued in TN
Practice address
397 Wallace Rd
Suite 407
Nashville, TN 37211-4854
Phone
(615) 942-1040
Fax
(615) 942-1060
NPI assigned
Oct 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN162359 TN
Nurse Practitioner 363L00000X 13772 TN Primary

Addresses

Primary practice location

397 Wallace Rd
Suite 407
Nashville, TN 37211-4854

Mailing address

397 Wallace Rd
Suite 407
Nashville, TN 37211-4854
Phone (615) 942-1040

Other identifiers 1

IdentifierTypeStateIssuer
1510685MedicaidTN

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13772TNMDNurse Practitioner
RN162359TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Pediatrics PC PastSince Oct 1, 2012 Accepting new patients
Pediatric Partners of Nashville, PLLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1508017393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 WALLACE RD",
            "address_2": "SUITE 407",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372114854",
            "telephone_number": "615-942-1040",
            "fax_number": "615-942-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 WALLACE RD",
            "address_2": "SUITE 407",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372114854",
            "telephone_number": "615-942-1040",
            "fax_number": "615-942-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREY",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "RN162359",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "13772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510685",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.