Cory M Sharp, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085005223 Issued in IL

Practice address

3400 Griffin Ave
Pekin, IL 61554-6246

Phone

(309) 347-4277

Fax

(309) 347-4388

NPI assigned

Sep 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1528460748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 GRIFFIN AVE",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546246",
            "telephone_number": "309-347-4277",
            "fax_number": "309-347-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 GRIFFIN AVE",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546246",
            "telephone_number": "309-347-4277",
            "fax_number": "309-347-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "CORY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Page V Settles, MD
• Huma Shamim, MD
• Melissa Shane
• Jessie Shanks, LMHC, LCPC
• Amanda Sharp-Potter
• Timothy Dane Shelley, O.D.
• Alison Sherren, AU.D., CCC-A
• Cindy Ann Sidell, DSP RSA CNA
• Janice C Sigulas, P. T.
• Dawn Sikorski, LOTR,CHT

• Physician Assistant in Pekin, IL
• Providers in Pekin, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.