Active NPI
Candace Corson, M.D.
- Family Medicine Physician
- Granger, IN
National Provider Identifier
1902137060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01038445A
- Practice address
- 16641 Brick Rd
Granger, IN 46530-8518 - Phone
- (574) 273-1763
- NPI assigned
- Jan 28, 2010
- Last updated
- Jan 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01038445A | IN | Primary |
Addresses
Primary practice location
16641 Brick Rd
Granger, IN 46530-8518
Mailing address
16641 Brick Rd
Granger, IN 46530-8518
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01038445A | IN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264636800000",
"number": "1902137060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16641 BRICK RD",
"city": "GRANGER",
"state": "IN",
"postal_code": "465308518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16641 BRICK RD",
"city": "GRANGER",
"state": "IN",
"postal_code": "465308518",
"telephone_number": "574-273-1763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORSON",
"first_name": "CANDACE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-28",
"last_updated": "2010-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01038445A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granger, IN
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- Ronald A. Craker, PSY.D.
- Christa Marie Crawford, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.