Individual provider Active NPI

Shanna Kornegay Corley, FNP-C

  • Family Nurse Practitioner
  • New Bern, NC
National Provider Identifier
1740988930
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5017703 Issued in NC
Practice address
702 Newman Rd
New Bern, NC 28562-5238
Phone
(252) 633-5333
Fax
(252) 633-9443
NPI assigned
Feb 17, 2023
Last updated
Feb 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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 5017703 NC Primary

Addresses

Primary practice location

702 Newman Rd
New Bern, NC 28562-5238

Mailing address

P.O. Box 12248
New Bern, NC 28561-2248
Phone (252) 514-6685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230419003213 NC Practitioner - Nurse Practitioner 4688039985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Carolina Health Care PAGroup PAC ID 9739087693, 122 clinicians

Practice addresses (Care Compare)

702 Newman Rd
New Bern, NC 28562-5238
Phone (252) 633-5333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5017703NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Health Care PA CurrentSince Feb 27, 2023 Accepting new patients
Coastal Carolina Health Care PA Current Accepting new patients
Coastal Carolina Health Care PA Current Accepting new patients
Coastal Carolina Health Care PA CurrentSince Feb 27, 2023 Accepting new patients
Coastal Carolina Health Care, PA Past Accepting new patients

Locations

1020 Medical Park Ave
New Bern, NC 28562
Phone (252) 514-6685

1040 Medical Park Ave
New Bern, NC 28562
Phone (252) 633-1678

702 Newman Rd
New Bern, NC 28562
Phone (252) 633-5333

Interoperability endpoints

  • Direct secure messaging: scorley27092@coastalcarolinahealthcenter.gardenplot.direct-ci.com

Organizations & group practices 5

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 2

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": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1740988930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 12248",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285612248",
            "telephone_number": "252-514-6685",
            "fax_number": "252-514-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625238",
            "telephone_number": "252-633-5333",
            "fax_number": "252-633-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "SHANNA",
        "middle_name": "KORNEGAY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5017703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.