Keisha Corbett

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

324434 Issued in NC

Practice address

3580 NC 14
Reidsville, NC 27320-8746

Phone

(336) 522-5095

NPI assigned

Oct 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1740887264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 IRVING AVE",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885618",
            "telephone_number": "336-344-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 NC 14",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208746",
            "telephone_number": "336-522-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBETT",
        "first_name": "KEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "323434",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "324434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323434",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Manuel Cole, LCSW
• Seth Peter Cole, CSAC
• Carrie Marlena Coleman, LCSWA
• Amanda Griffin Comer, FNP-C
• Shynese Cooper
• Cornerstone Health Care, LLC
• Dawn Madren Corum, LPN
• James Randall Cothran, CSAC
• Mark Christopher Cotter, O.D.
• Frances Hough Cresenzo-Dishmon, CNM

• All providers in Reidsville, NC
• Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.