Individual provider Active NPI

Mandy Lynn Corvino, FNP-BC

  • Family Nurse Practitioner
  • Salem, OH
National Provider Identifier
1659942647
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.NP.0029151 Issued in OH
Practice address
2364 Southeast Blvd
Salem, OH 44460-3418
Phone
(330) 337-1134
NPI assigned
Jul 9, 2021
Last updated
Jul 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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 APRN.NP.0029151 OH Primary

Addresses

Primary practice location

2364 Southeast Blvd
Salem, OH 44460-3418

Mailing address

469 Jaronte Dr
Boardman, OH 44512-4432
Phone (330) 727-5994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20211004000438 OH Practitioner - Nurse Practitioner 2466850631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Urology Institute IncGroup PAC ID 9638438245, 4 clinicians

Practice addresses (Care Compare)

2360 Southeast Blvd
Salem, OH 44460-3418
Phone (330) 337-1134

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.NP.0029151OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Urology Institute Inc. CurrentSince Oct 1, 2021 Accepting new patients

Locations

3660 Stutz Dr
Ste 202
Canfield, OH 44406
Phone (330) 286-3156

2360 Southeast Blvd
Salem, OH 44460
Phone (330) 337-1134

2364 Southeast Blvd
Salem, OH 44460
Phone (330) 332-4833

Organizations & group practices 1

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1659942647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 JARONTE DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124432",
            "telephone_number": "330-727-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 SOUTHEAST BLVD",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444603418",
            "telephone_number": "330-337-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORVINO",
        "first_name": "MANDY",
        "middle_name": "LYNN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.NP.0029151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OH

Sources for this page

Verify at the official NPI Registry.