Individual provider Active NPI

Corissa Nicole Hockman, DO

  • Pediatrics Physician
  • Winchester, VA
National Provider Identifier
1801380563
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0102207302 Issued in VA
Practice address
1840 Amherst St
Winchester, VA 22601-2808
Phone
(540) 536-8000
Fax
(540) 836-3286
NPI assigned
Jun 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 0102207302 VA
Pediatrics Physician 208000000X 34014904 OH
Hospitalist Physician 208M00000X 34014904 OH
Pediatrics Physician 208000000X 0102207302 VA Primary

Addresses

Primary practice location

1840 Amherst St
Winchester, VA 22601-2808

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other identifiers 1

IdentifierTypeStateIssuer
0432671MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230209003004 DC Practitioner - HospitalistPractitioner - Pediatric Medicine 9739598582 Reassigns benefits to 1 organization
I20230313002105 VA Practitioner - HospitalistPractitioner - Pediatric Medicine 9739598582 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34014904OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services Pediatrics CurrentSince Dec 5, 2022 Accepting new patients
Inova Health Care Services CurrentSince Dec 5, 2022 Accepting new patients
Winchester Medical Center Past Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Interoperability endpoints

  • Direct secure messaging: chockman1180063@soc.inova.org

Organizations & group practices 4

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1801380563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012808",
            "telephone_number": "540-536-8000",
            "fax_number": "540-836-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCKMAN",
        "first_name": "CORISSA",
        "middle_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0102207302",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34014904",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "34014904",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102207302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0432671",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.