Corinne Mary Koch-Blaydon, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP014883 Issued in PA

Practice address

57 Oak Grove Rd
Ottsville, PA 18942-9748

Phone

(610) 751-8358

NPI assigned

Apr 25, 2015

Sex

Female

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

Nurse Practitioner

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

{
    "created_epoch": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429920000000",
    "number": "1588051775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 OAK GROVE RD",
            "city": "OTTSVILLE",
            "state": "PA",
            "postal_code": "189429748",
            "telephone_number": "610-751-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 OAK GROVE RD",
            "city": "OTTSVILLE",
            "state": "PA",
            "postal_code": "189429748",
            "telephone_number": "610-751-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH-BLAYDON",
        "first_name": "CORINNE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-25",
        "last_updated": "2015-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP014883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Gustafson, RN
• Marianne Harms, LCSW
• Mora Eileen Harte
• Kristann Wilmore Heinz, M.D.
• Cynthia Hofmann, CNHP, NTP, NRT
• Kristi L Kotz, DO
• Samuel Irwin Krinsky, MD
• Larry F. Rakowsky, D.M.D., P.C.
• Elise Leuenberger
• Susan R. Lipson, M.D.

• Nurse Practitioner in Ottsville, PA
• Providers in Ottsville, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2015; 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.