Individual provider Active NPI

Korrin Einertson, PA-C

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1710553540
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2021041375 Issued in MO
Practice address
100 S 4TH St Ste 550
Saint Louis, MO 63102-1897
Phone
(919) 391-7202
NPI assigned
Jun 2, 2021
Last updated
May 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2021041375 MO Primary

Addresses

Primary practice location

100 S 4TH St Ste 550
Saint Louis, MO 63102-1897

Mailing address

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone (919) 391-7202

Other practice location 1

2741 Campus Walk Ave Ste 200
Durham, NC 27705-8878
Phone (919) 391-7202

Other practice location 2

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone (919) 391-7202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230613001806 MO Practitioner - Physician Assistant 4981061538 Reassigns benefits to 3 organizations
I20260507001354 NC Practitioner - Physician Assistant 4981061538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

505 Wellingham Dr
Durham, NC 27713-7501

5501 Fortunes Ridge Dr
Suite P
Durham, NC 27713-6102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Animo Sano Psychiatry PLLC CurrentSince Jun 1, 2026 Accepting new patients

Locations

100 S 4th St
Ofc 552
Saint Louis, MO 63102

100 S 4th St
Ste 550
Saint Louis, MO 63102
Phone (314) 391-2626

2741 Campus Walk Ave
Bldg 400
Durham, NC 27705
Phone (919) 973-4617

5501 Fortunes Ridge Dr
Ste P
Durham, NC 27713
Phone 9193917202908

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1710553540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR STE P",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "919-391-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S 4TH ST STE 550",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631021897",
            "telephone_number": "919-391-7202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2741 Campus Walk Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277058878",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "fax_number": "919-391-7203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 Fortunes Ridge Dr Ste P",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277136102",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EINERTSON",
        "first_name": "KORRIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021041375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.