Individual provider Active NPI

Thomas Lawrence Corey III, CRNA

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1780351080
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
7064 Issued in NC
Practice address
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone
(704) 355-2000
NPI assigned
Aug 24, 2021
Last updated
Dec 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 7064 NC Primary
Registered Nurse 163W00000X 278042 NC

Addresses

Primary practice location

1000 Blythe Blvd
Charlotte, NC 28203-5812

Mailing address

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230209000235 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901278464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

201 E Grover St
Shelby, NC 28150-3917
Phone (980) 487-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
278042NCMDRegistered Nurse
7064NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Anesthesia Services Group Inc CurrentSince Feb 1, 2023 Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

201 E Grover St
Shelby, NC 28150
Phone (704) 487-3000

Organizations & group practices 1

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 6

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1780351080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREY",
        "first_name": "THOMAS",
        "middle_name": "LAWRENCE",
        "name_suffix": "III",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "7064",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "278042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.