Individual provider Active NPI

Jayison McCorkle, FNP-BC

  • Family Nurse Practitioner
  • Shorewood, IL
National Provider Identifier
1831588979
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209012391 Issued in IL
Practice address
850 Brook Forest Ave
Shorewood, IL 60404-8513
Phone
(815) 436-2278
NPI assigned
Jan 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN002024 NV
Family Nurse Practitioner 363LF0000X 209012391 IL Primary

Addresses

Primary practice location

850 Brook Forest Ave
Shorewood, IL 60404-8513

Mailing address

22228 Heritage Dr
Frankfort, IL 60423-8523
Phone (708) 560-6017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20151118002288 NV Practitioner - Nurse Practitioner 2163748914 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity-Nevada Medical Services Koury and Partners PCGroup PAC ID 2163968603, 64 clinicians

Practice addresses (Care Compare)

102 E Lake Mead Pkwy
Henderson, NV 89015-5575
Phone (702) 616-4600

Hospital & facility affiliations

  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045
  • Saint Rose Dominican Hospitals - San Martin Campus Hospital, Las Vegas, NV, CCN 290053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209012391ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-Nevada Medical Services Koury & Partners PC CurrentSince Jul 9, 2024 Accepting new patients
Vituity-Nevada Medical Services Koury & Partners PC CurrentSince Jul 9, 2024 Accepting new patients
Vituity-Nevada Medical Services Koury & Partners PC Current Accepting new patients
Ram K Singh M D LTD CurrentSince May 26, 2019 Accepting new patients
Yang Medical Services, PLLC CurrentSince Aug 17, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622

3001 Saint Rose Pkwy
Henderson, NV 89052
Phone (702) 615-5000

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

4980 W Sahara Ave
Ste 100
Las Vegas, NV 89146
Phone (702) 216-7365

4432 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 733-2982

1181 Grier Dr
Ste C
Las Vegas, NV 89119
Phone (888) 888-9930

8280 W Warm Springs Rd
Las Vegas, NV 89113
Phone (702) 458-5099

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1831588979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22228 HERITAGE DR",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604238523",
            "telephone_number": "708-560-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BROOK FOREST AVE",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048513",
            "telephone_number": "815-436-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORKLE",
        "first_name": "JAYISON",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-13",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002024",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

Verify at the official NPI Registry.