Individual provider Active NPI

Corin Elizabeth Dickinson, MSN, FNP-C

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1871102152
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP022407 Issued in PA
Practice address
4417 N 6TH St
Philadelphia, PA 19140-2319
Phone
(215) 302-3600
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 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 SP022407 PA Primary
Registered Nurse 163W00000X 649857 PA

Addresses

Primary practice location

4417 N 6TH St
Philadelphia, PA 19140-2319

Mailing address

4417 N 6TH St
Philadelphia, PA 19140-2319
Phone (215) 302-3600

Other practice location 1

2940 N 5th St
Philadelphia, PA 19133-2801
Phone (215) 302-3600

Other practice location 2

861 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone (215) 302-3600

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
I20201119002580 PA Practitioner - Nurse Practitioner 5698186849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esperanza Health Center, Inc.Group PAC ID 6103815071, 32 clinicians

Practice addresses (Care Compare)

861 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone (215) 302-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
649857PAMDRegistered Nurse
SP022407PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza Health Center, Inc. CurrentSince Oct 12, 2020 Accepting new patients
Esperanza Health Center, Inc. Past Accepting new patients

Locations

861 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 302-3600

2940 N 5th St
Philadelphia, PA 19133
Phone (215) 221-6633

4417 N 6th St
Philadelphia, PA 19140
Phone (215) 302-3150

Organizations & group practices 2

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": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1871102152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2940 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191332801",
            "country_code": "US",
            "telephone_number": "215-302-3600",
            "fax_number": "215-329-2369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "861 E Allegheny Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191342401",
            "country_code": "US",
            "telephone_number": "215-302-3600",
            "fax_number": "215-329-2369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "CORIN",
        "middle_name": "ELIZABETH",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2025-01-03",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022407",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "649857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.