Active NPI
Mabel McCorrison, FNP
- Nurse Practitioner
- Boones Mill, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 0024166899
- Practice address
- 22890 Virgil Goode Hwy
Boones Mill, VA 24065 - Phone
- (540) 344-5511
- Fax
- (540) 344-3174
- NPI assigned
- Sep 22, 2006
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0024166899 | VA | Primary |
| Family Nurse Practitioner | 363LF0000X | 0024166899 | VA |
Addresses
Primary practice location
22890 Virgil Goode Hwy
Boones Mill, VA 24065
Mailing address
213 S Jefferson St Ste 625
Roanoke, VA 24011-1713
Phone (540) 224-5516
Other practice location 1
3745 Holland Rd
Virginia Beach, VA 23452-2847
Phone (757) 962-8720
Other practice location 2
21054A Timberlake Rd
Lynchburg, VA 24502-7327
Phone (434) 239-0627
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | VA | |
| 1639278690 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22890 Virgil Goode Hwy
Boones Mill, VA 24065
Phone (540) 334-5511
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024166899 | VA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carilion Giles Community Hospital | Current | Accepting new patients | |
| Carilion Healthcare Corporation | Current | Accepting new patients | |
| Carilion Healthcare Corporation | Current | Accepting new patients | |
| Carilion Giles Community Hospital | Current | Accepting new patients | |
| Carilion Giles Community Hospital | Current | Accepting new patients | |
| Southeastern Emergency Services P C | Nurse Practitioner | Past | Accepting new patients |
Locations
159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000
213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677
6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110
Interoperability endpoints
- mmccorrison129499@direct.carilionclinic.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Critical Access Hospital
- Pearisburg, VA
- NPI 1194718304
-
dba Bridgewater College Student Health Center
- Multi-Specialty Clinic/Center
- Roanoke, VA
- NPI 1447206370
-
- Durable Medical Equipment & Medical Supplies
- Galax, VA
- NPI 1639980493
-
dba Carilion Clinic Family Medicine
- Rural Health Clinic/Center
- Wytheville, VA
- NPI 1699393736
-
- Durable Medical Equipment & Medical Supplies
- Blacksburg, VA
- NPI 1407667256
-
- Nurse Practitioner
- Athens, TN
- NPI 1669414264
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rocky Mount, VA
- NPI 1710970918
-
- Hospitalist Physician
- Pearisburg, VA
- NPI 1023663267
-
- Emergency Medicine Physician
- Pearisburg, VA
- NPI 1164076634
Hospital
-
- Critical Access Hospital
- Pearisburg, VA
- NPI 1194718304
-
- Multi-Specialty Clinic/Center
- Pearisburg, VA
- NPI 1346894813
Hospital
-
dba Carilion Roanoke Memorial Hospital
- General Acute Care Hospital
- Roanoke, VA
- NPI 1033102942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1639278690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 S JEFFERSON ST STE 625",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240111713",
"telephone_number": "540-224-5516",
"fax_number": "540-224-5684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22890 VIRGIL GOODE HWY",
"city": "BOONES MILL",
"state": "VA",
"postal_code": "24065",
"telephone_number": "540-344-5511",
"fax_number": "540-344-3174"
}
],
"practiceLocations": [
{
"address_1": "3745 Holland Rd",
"address_purpose": "LOCATION",
"city": "Virginia Beach",
"state": "VA",
"postal_code": "234522847",
"country_code": "US",
"telephone_number": "757-962-8720",
"fax_number": "757-507-9004",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "21054A Timberlake Rd",
"address_purpose": "LOCATION",
"city": "Lynchburg",
"state": "VA",
"postal_code": "245027327",
"country_code": "US",
"telephone_number": "434-239-0627",
"fax_number": "434-237-0345",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCORRISON",
"first_name": "MABEL",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2022-07-21",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "VA",
"license": "0024166899",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024166899",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1639278690",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boones Mill, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.