Corey Lee Pittman

Primary specialty

DriverTaxonomy code 172A00000X

License

20568756 Issued in AZ

Practice address

1225 N 159TH Dr
Goodyear, AZ 85338-2753

Phone

(602) 672-2853

Fax

(623) 932-2096

NPI assigned

Jan 10, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Corey Lee Pittman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1861762627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 N 159TH DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382753",
            "telephone_number": "602-672-2853",
            "fax_number": "623-932-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N 159TH DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382753",
            "telephone_number": "602-672-2853",
            "fax_number": "623-932-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "COREY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-10",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "AZ",
            "license": "20568756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COREY",
            "last_name": "PITTMAN",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin Richard Picciano, MD
• Brianna Lavonne Piepenbrok, DPT
• Christopher Pieper, LIAC
• Hugo L Pinillos, M.D.
• Bethany Amber Pinkowski, RN
• Kyle Pizarro, DO
• Pkwy Medical Center LLC
• Bruce James Ploeser, PA-C
• Ronald A Plotkin, O.D.
• Patricia Ann Plum, LCSW

• Driver in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Driver in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.