Lisa Rena Corbin

Primary specialty

SpecialistTaxonomy code 174400000X

License

1201092084 Issued in VA

Practice address

1580 Crossways Blvd Ste 103
Chesapeake, VA 23320-0206

Phone

(757) 567-2698

NPI assigned

Aug 17, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Lisa Rena McKinley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Exquisite Beauty Hair Replacement Center

  • Durable Medical Equipment & Medical Supplies
  • Chesapeake, VA
  • NPI 1346862042
  NPD Authorized official

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1659047074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 CROSSWAYS BLVD 103 SUITE 12",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202031",
            "telephone_number": "757-567-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 CROSSWAYS BLVD STE 103",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200206",
            "telephone_number": "757-567-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "LISA",
        "middle_name": "RENA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "1201092084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MCKINLEY",
            "middle_name": "RENA",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Specialist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; 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.