Active NPI
Corinne R Ponzi, PA-C
- Physician Assistant
- Odenton, MD
National Provider Identifier
1891014999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9104925
- Practice address
- 1130 Annapolis Rd Ste 101
Odenton, MD 21113-1622 - Phone
- (410) 672-2255
- NPI assigned
- May 28, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9104925 | FL | Primary |
Addresses
Primary practice location
1130 Annapolis Rd Ste 101
Odenton, MD 21113-1622
Mailing address
1130 Annapolis Rd Ste 101
Odenton, MD 21113-1622
Phone (410) 672-2255
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9104925 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602460800000",
"number": "1891014999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 ANNAPOLIS RD STE 101",
"city": "ODENTON",
"state": "MD",
"postal_code": "211131622",
"telephone_number": "410-672-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 ANNAPOLIS RD STE 101",
"city": "ODENTON",
"state": "MD",
"postal_code": "211131622",
"telephone_number": "410-672-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONZI",
"first_name": "CORINNE",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-28",
"last_updated": "2020-10-12",
"certification_date": "2020-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9104925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odenton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.