Individual provider Active NPI

James T Corum Jr., PHYSICAL THERAPIST

  • Physical Therapist
  • Middlesboro, KY
National Provider Identifier
1790075745
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005704 Issued in KY
Practice address
1847 N 25TH St
Middlesboro, KY 40965-1853
Phone
(606) 248-1996
Fax
(606) 248-1901
NPI assigned
Apr 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 005704 KY Primary

Addresses

Primary practice location

1847 N 25TH St
Middlesboro, KY 40965-1853

Mailing address

PO Box 824
Middlesboro, KY 40965-0824
Phone (606) 248-1996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111025000575 KY Practitioner - Physical Therapist in Private Practice 7315110038 Reassigns benefits to 2 organizations
I20130919000348 TN Practitioner - Physical Therapist in Private Practice 7315110038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elevation Therapy LLCGroup PAC ID 2062832629, 12 clinicians

Practice addresses (Care Compare)

1510 Cumberland Ave
Middlesboro, KY 40965-1223
Phone (606) 302-5474

430 S Broad St
New Tazewell, TN 37825-7239
Phone (423) 441-8848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9806TNMDPharmacist
005704KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elevation Therapy, LLC Physical Therapist CurrentSince Apr 1, 2021 Accepting new patients
Champion Physical Therapy Kentucky LLC CurrentSince Mar 26, 2018 Accepting new patients
Champion Physical Therapy Kentucky, LLC Physical Therapist CurrentSince Mar 26, 2018 Accepting new patients

Locations

1475 US Highway 25 E
Ste 6
Middlesboro, KY 40965
Phone (606) 248-1996

1510 Cumberland Ave
Middlesboro, KY 40965
Phone (606) 302-5474

1110 Shawnee Rd
Lima, OH 45805
Phone (419) 221-6720

430 S Broad St
New Tazewell, TN 37825
Phone (423) 441-8848

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1790075745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 824",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409650824",
            "telephone_number": "606-248-1996",
            "fax_number": "606-248-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 N 25TH ST",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651853",
            "telephone_number": "606-248-1996",
            "fax_number": "606-248-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORUM",
        "first_name": "JAMES",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.