Edward D Corley, DC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

CH00003648 Issued in WA

Practice address

4114 Bridgeport Way West
University Place, WA 98466

Phone

(253) 564-8100

Fax

(253) 564-8387

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Up Family Medicine PLLC

  • Health Service Clinic/Center
  • University Place, WA
  • NPI 1417577909
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1821151820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 BRIDGEPORT WAY WEST",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "98466",
            "telephone_number": "253-564-8100",
            "fax_number": "253-564-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 BRIDGEPORT WAY WEST",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "98466",
            "telephone_number": "253-564-8100",
            "fax_number": "253-564-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "EDWARD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH00003648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "CO5411",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Alie Conteh, EDD., LMHC
• Continuum Therapeutics, LLC
• Alta Katherine Corcilius
• Cordial Palace Afh LLC
• Cassondra Cordova, MHP, LMHCA
• Cornerstone Caregiving West LLC
• Bruce Edward Corns, LMP
• Cossmedic Wellness and Aesthetics PLLC
• Dawnna J Cotton, P1 60035244
• Edward Louis Coyle II, PH.D.

• Rehabilitation Chiropractor in University Place, WA
• Providers in University Place, WA by specialty
• Rehabilitation Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.