Individual provider Active NPI

Mark S Corman, MD

  • Psychiatry Physician
  • Florissant, MO
National Provider Identifier
1942332267
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2010006154 Issued in MO
Practice address
1150 Graham Rd Ste 102
Florissant, MO 63031-8077
Phone
(314) 206-3900
Fax
(314) 206-3992
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0431293 KS
Psychiatry Physician 2084P0800X 2010006154 MO Primary

Addresses

Primary practice location

1150 Graham Rd Ste 102
Florissant, MO 63031-8077

Mailing address

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone (314) 206-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120117000097 MO Practitioner - Psychiatry 5294803029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Kansas School of Med (KC/Wich/Sal), 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BJC Behavioral HealthGroup PAC ID 1153225271, shared by 2 NPIs, 63 clinicians

Practice addresses (Care Compare)

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone (314) 206-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2010006154MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BJC Behavioral Health CurrentSince Oct 19, 2011 Accepting new patients
BJC Behavioral Health CurrentSince Oct 19, 2011 Accepting new patients

Locations

1085 Maple St
Farmington, MO 63640
Phone (573) 756-5353

3309 S Kingshighway Blvd
Saint Louis, MO 63139
Phone (314) 534-9350

1430 Olive St
Ste 400
Saint Louis, MO 63103

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1942332267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391101",
            "telephone_number": "314-206-3700",
            "fax_number": "314-206-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 GRAHAM RD STE 102",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318077",
            "telephone_number": "314-206-3900",
            "fax_number": "314-206-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORMAN",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KS",
            "license": "0431293",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2010006154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.