Active NPI
Diana Lynn Korsog, RNFA
- Registered Nurse First Assistant
- Detroit, MI
National Provider Identifier
1669664371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse First Assistant
- License
- RN240284
- Practice address
- 4646 John R St
Detroit, MI 48201-1916 - Phone
- (313) 576-1000
- NPI assigned
- Aug 16, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | RN240284 | OH | Primary |
Addresses
Primary practice location
4646 John R St
Detroit, MI 48201-1916
Mailing address
4646 John R St
Detroit, MI 48201-1916
Phone (313) 576-1000
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN240284 | OH | MD | Registered Nurse First Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1669664371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011916",
"telephone_number": "313-576-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011916",
"telephone_number": "313-576-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORSOG",
"first_name": "DIANA",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "RNFA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-16",
"last_updated": "2022-09-27",
"certification_date": "2022-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "OH",
"license": "RN240284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.