Individual provider Active NPI

Corinne Helena Trusock, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1780738823
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9564 Issued in GA
Practice address
QSM-Ga, Inc-SNF
1821 Anderson Ave NW
Atlanta, GA 33014-1835
Phone
(305) 466-9988
Fax
(305) 466-9989
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9564 GA Primary
Physician Assistant 363A00000X 5601003291 MI

Addresses

Primary practice location

QSM-Ga, Inc-SNF
1821 Anderson Ave NW
Atlanta, GA 33014-1835

Mailing address

3800 S Ocean Dr Ste 209
Hollywood, FL 33019-2915
Phone (305) 466-9988

Other practice location 1

3250 Woods Way
Suite 9
Petoskey, MI 49770-7628
Phone (231) 881-9700

Other identifiers 2

IdentifierTypeStateIssuer
970020813OtherMIRAILROAD RETIREMENT
G86360OtherMAPRIORITY HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200423001799 GA Practitioner - Physician Assistant 2860562162 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601003291MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Cardiology, PLLC PastSince Mar 16, 2016 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23627/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1780738823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "QSM-GA, INC-SNF",
            "address_2": "1821 ANDERSON AVE NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "330141835",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3250 Woods Way",
            "address_2": "Suite 9",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497707628",
            "country_code": "US",
            "telephone_number": "231-881-9700",
            "fax_number": "231-881-9698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUSOCK",
        "first_name": "CORINNE",
        "middle_name": "HELENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9564",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT",
            "identifier": "970020813",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "G86360",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.