Individual provider Active NPI

Evelyn Corley, APRN FNP-BC

  • Family Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1699177758
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP133811 Issued in TX
Practice address
820 S Carrier Pkwy
Grand Prairie, TX 75051-1517
Phone
(972) 262-1425
Fax
(972) 262-4973
NPI assigned
Sep 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R084623 AR
Family Nurse Practitioner 363LF0000X A004224 AR
Family Nurse Practitioner 363LF0000X AP133811 TX Primary

Addresses

Primary practice location

820 S Carrier Pkwy
Grand Prairie, TX 75051-1517

Mailing address

820 S Carrier Pkwy
Grand Prairie, TX 75051-1517
Phone (972) 262-1425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190618001011 TX Practitioner - Nurse Practitioner 1759603236 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R084623ARMDRegistered Nurse
A004224ARMDFamily Nurse Practitioner
AP133811TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince May 1, 2019 Accepting new patients
Medhealth Current Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients

Locations

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

820 S Carrier Pkwy
Grand Prairie, TX 75051
Phone (972) 262-1425

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1699177758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511517",
            "telephone_number": "972-262-1425",
            "fax_number": "972-262-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511517",
            "telephone_number": "972-262-1425",
            "fax_number": "972-262-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "EVELYN",
        "credential": "APRN FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-20",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R084623",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004224",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.