Individual provider Active NPI

Mary Anne Corder, RN,MSN,FNP-C

  • Family Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1568676807
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-06461 Issued in OH
Practice address
2940 N McCord Rd
Toledo, OH 43615-1753
Phone
(419) 842-3000
Fax
(419) 842-3042
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP-06461 OH Primary

Addresses

Primary practice location

2940 N McCord Rd
Toledo, OH 43615-1753

Mailing address

2940 N McCord Rd
Toledo, OH 43615-1753
Phone (419) 842-3000

Other identifiers 2

IdentifierTypeStateIssuer
2241121MedicaidOH
CONP81401OtherOHMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcorder13403@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110415000307 MI Practitioner - Nurse Practitioner 5597846717 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
NP-06461OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Toledo Physicians, LLC Past Accepting new patients
University of Toledo Physicians LLC Past Accepting new patients
Emergency Physicians of Northwest Ohio Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Observation Physicians of Northwest Ohio LLC PastSince Mar 21, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9641/brand/2/csg/1/fhir/r4
  • Direct secure messaging: mcorder13403@direct.promedica.org

Organizations & group practices 6

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1568676807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 N MCCORD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151753",
            "telephone_number": "419-842-3000",
            "fax_number": "419-842-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 N MCCORD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151753",
            "telephone_number": "419-842-3000",
            "fax_number": "419-842-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDER",
        "first_name": "MARY",
        "middle_name": "ANNE",
        "credential": "RN,MSN,FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP-06461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2241121",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CONP81401",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcorder13403@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.