Individual provider Active NPI

Koren Olivia Corbett, CNM

  • Advanced Practice Midwife
  • Portland, OR
National Provider Identifier
1780056879
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
201508263NP-PP Issued in OR
Practice address
5050 NE Hoyt St Ste 362
Portland, OR 97213-2983
Phone
(503) 239-6800
Fax
(503) 239-0006
NPI assigned
Oct 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 201508263NP-PP OR Primary

Addresses

Primary practice location

5050 NE Hoyt St Ste 362
Portland, OR 97213-2983

Mailing address

847 NE 19TH Ave
Suite 300
Portland, OR 97232-2684
Phone (503) 963-2801

Other practice location 1

5050 NE Hoyt St Ste 353
Portland, OR 97213-2983
Phone (503) 239-6800

Other identifiers 1

IdentifierTypeStateIssuer
500701561MedicaidOR

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address kcorbett274645@oc.providencedirect.org
Direct Messaging Address kcorbett274645@oc.providencedirect.org
Direct Messaging Address kcorbett274645@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
201508263NP-PPORMDAdvanced Practice Midwife

Interoperability endpoints

  • Direct secure messaging: kcorbett274645@oc.providencedirect.org

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1780056879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322684",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 362",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132983",
            "telephone_number": "503-239-6800",
            "fax_number": "503-239-0006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5050 NE Hoyt St Ste 353",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972132983",
            "country_code": "US",
            "telephone_number": "503-239-6800",
            "fax_number": "503-239-0006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORBETT",
        "first_name": "KOREN",
        "middle_name": "OLIVIA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "201508263NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500701561",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcorbett274645@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "545 NE 47th Ave Ste 102",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcorbett274645@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10330 SE 32nd Ave Ste 305",
            "city": "Milwaukie",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972226596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcorbett274645@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9135 SW Barnes Rd Ste 761",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.