Individual provider Active NPI

Corrin M Fesko

  • Nurse Practitioner
  • Johnstown, PA
National Provider Identifier
1790234052
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP016585 Issued in PA
Practice address
315 Locust St
2ND FL
Johnstown, PA 15901-1651
Phone
(814) 534-6750
Fax
(814) 534-6760
NPI assigned
Sep 28, 2016
Last updated
Sep 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP016585 PA Primary

Addresses

Primary practice location

315 Locust St
2ND FL
Johnstown, PA 15901-1651

Mailing address

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 410-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20161129000062 PA Practitioner - Nurse Practitioner 2264712751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

315 Locust St
Suite 2
Johnstown, PA 15901-1651
Phone (814) 534-6750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Nurse Practitioner CurrentSince Oct 17, 2016 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Oct 17, 2016 Accepting new patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
Conemaugh Health Initiatives Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1 Tech Park Dr
Ste 1200
Johnstown, PA 15901
Phone (814) 534-6750

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

315 Locust St
Ste 2
Johnstown, PA 15901
Phone (814) 534-6242

320 Main St
Johnstown, PA 15901
Phone (814) 533-0123

Interoperability endpoints

  • Direct secure messaging: cfesko6071@direct.conemaugh.org

Organizations & group practices 5

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": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1790234052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-410-8300",
            "fax_number": "814-410-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 LOCUST ST",
            "address_2": "2ND FL",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159011651",
            "telephone_number": "814-534-6750",
            "fax_number": "814-534-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FESKO",
        "first_name": "CORRIN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP016585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.