Cory Tyler Brown, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024178307 Issued in VA

Practice address

1113 Cedar Valley Dr
Cedar Bluff, VA 24609-9190

Phone

(276) 963-0111

NPI assigned

Oct 26, 2019

Last updated

Oct 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

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  • Richlands, VA
  • NPI 1124329388
  Medicare reassignment NPD

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

{
    "created_epoch": "1572048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572048000000",
    "number": "1760025365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 426",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246090426",
            "telephone_number": "276-963-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 CEDAR VALLEY DR",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246099190",
            "telephone_number": "276-963-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CORY",
        "middle_name": "TYLER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-26",
        "last_updated": "2019-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trista Blankenship
• Gretchen Anne Blevins, LPC
• Gladys M Boone, OTR
• Leean Brooks, RD
• Christy Laraine Brown
• Kimberly Denise Bryant, LCSW
• Christopher Robert Buchanan, LCSW
• Donna Callis, LCSW
• Cynthia Carty
• Crystal Chafin

• Family Nurse Practitioner in Cedar Bluff, VA
• Providers in Cedar Bluff, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.