Individual provider Active NPI

Marjorie Corker-Holzer, MD

  • Pediatrics Physician
  • Putnam, CT
National Provider Identifier
1609052521
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
022422 Issued in CT
Practice address
320 Pomfret St
Putnam, CT 06260-1836
Phone
(860) 928-6541
Fax
(860) 963-6343
NPI assigned
Jan 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 022422 CT Primary

Addresses

Primary practice location

320 Pomfret St
Putnam, CT 06260-1836

Mailing address

320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 928-6541

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1609052521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836",
            "telephone_number": "860-928-6541",
            "fax_number": "860-963-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836",
            "telephone_number": "860-928-6541",
            "fax_number": "860-963-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORKER-HOLZER",
        "first_name": "MARJORIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "022422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.