Individual provider Active NPI

McLellan Jane Corum

  • Student in an Organized Health Care Education/Training Program
  • Greensboro, NC
National Provider Identifier
1881204816
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1400 Spring Garden St
Greensboro, NC 27412-5015
Phone
(336) 334-5000
NPI assigned
Aug 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X NC
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X NC Primary

Addresses

Primary practice location

1400 Spring Garden St
Greensboro, NC 27412-5015

Mailing address

3844 Battleground Ave Apt 32
Greensboro, NC 27410-9433
Phone (336) 609-3129

Other practice location 1

3844 Battleground Ave Apt 32
Greensboro, NC 27410-9433
Phone (336) 609-3129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1881204816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3844 BATTLEGROUND AVE APT 32",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109433",
            "telephone_number": "336-609-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SPRING GARDEN ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274125015",
            "telephone_number": "336-334-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3844 Battleground Ave Apt 32",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274109433",
            "country_code": "US",
            "telephone_number": "336-609-3129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORUM",
        "first_name": "MCLELLAN",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.