Individual provider Active NPI

Corey T Kocisko, CRNA

  • Certified Registered Nurse Anesthetist
  • Cookeville, TN
National Provider Identifier
1891408399
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
143807 Issued in GA
Practice address
1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone
(931) 528-2541
NPI assigned
Dec 29, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 143807 GA Primary

Addresses

Primary practice location

1 Medical Center Blvd
Cookeville, TN 38501-4294

Mailing address

7312 Martingale Dr
Powell, TN 37849-5159
Phone (731) 307-0360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230403000728 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820463904 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia VIII PLLCGroup PAC ID 3173984762, 155 clinicians
Resource Anesthesia, P.C.Group PAC ID 1254228141, 71 clinicians

Practice addresses (Care Compare)

10820 Parkside Dr
Knoxville, TN 37934-1956
Phone (865) 546-8040

110 Hospital Dr
Jefferson City, TN 37760-5281
Phone (865) 859-1138

550 Fort Loudon Medical Ctr Dr
Lenoir City, TN 37772-5673
Phone (888) 854-3822

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
143807GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2024 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Jan 13, 2024 Accepting new patients
Lifelinc Anesthesia II, PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2023 Accepting new patients
Lifelinc Anesthesia VIII PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2024 Accepting new patients
Covenant Anesthesia Group, PC CurrentSince Oct 3, 2024 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 13, 2024 Accepting new patients
University Anesthesiologists, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2024 Accepting new patients
University Anesthesiologists, PLLC Past Accepting new patients

Locations

105 N Meadows Dr
Athens, TN 37303
Phone (423) 649-3300

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

110 Hospital Dr
Jefferson Cty, TN 37760
Phone (865) 471-2431

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

1924 Alcoa Hwy
#U109
Knoxville, TN 37920
Phone (865) 305-9220

10820 Parkside Dr
Knoxville, TN 37934
Phone (865) 218-7011

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

Dept 888089
Knoxville, TN 37995

550 Fort Loudon Medical Center Dr
#C
Lenoir City, TN 37772

550 Fort Loudoun Med Center Dr
Lenoir City, TN 37772
Phone (865) 271-6000

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000

7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000

100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531

6242 W Andrew Johnson Hwy
Talbott, TN 37877
Phone (423) 690-3250

1850 Old Knoxville Rd
Tazewell, TN 37879
Phone (423) 526-2137

Organizations & group practices 8

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 3

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": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1891408399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7312 MARTINGALE DR",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378495159",
            "telephone_number": "731-307-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014294",
            "telephone_number": "931-528-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCISKO",
        "first_name": "COREY",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "143807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.