Active NPI
Corlene Aleta Becker, RN
- Registered Nurse
- Genesee, ID
National Provider Identifier
1508040023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- N-16760
- Practice address
- 2301 Krier Rd
Genesee, ID 83832 - Phone
- (208) 285-1178
- NPI assigned
- Dec 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | N-16760 | ID | Primary |
Addresses
Primary practice location
2301 Krier Rd
Genesee, ID 83832
Mailing address
PO Box 417
Genesee, ID 83832
Phone (208) 285-1178
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805589100 | Medicaid | ID |
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N-16760 | ID | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198022400000",
"number": "1508040023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 417",
"city": "GENESEE",
"state": "ID",
"postal_code": "83832",
"telephone_number": "208-285-1178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 KRIER RD",
"city": "GENESEE",
"state": "ID",
"postal_code": "83832",
"telephone_number": "208-285-1178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "CORLENE",
"middle_name": "ALETA",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-19",
"last_updated": "2007-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ID",
"license": "N-16760",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805589100",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Genesee, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.