Active NPI
Annetta J Corcoran, RD,LD
- Registered Dietitian
- Defiance, OH
National Provider Identifier
1942563481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD4032
- Practice address
- 1400 E 2ND St
Defiance, OH 43512-2440 - Phone
- (419) 784-1414
- Fax
- (419) 783-2799
- NPI assigned
- Jun 20, 2012
- Last updated
- Jul 13, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD4032 | OH | Primary |
Addresses
Primary practice location
1400 E 2ND St
Defiance, OH 43512-2440
Mailing address
2200 Jefferson Ave
4TH Floor Credentialing
Toledo, OH 43604-7101
Phone (419) 251-8983
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4032 | OH | MD | Chiropractor |
| LD4032 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342137600000",
"number": "1942563481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 JEFFERSON AVE",
"address_2": "4TH FLOOR CREDENTIALING",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436047101",
"telephone_number": "419-251-8983",
"fax_number": "419-251-6719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E 2ND ST",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435122440",
"telephone_number": "419-784-1414",
"fax_number": "419-783-2799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORCORAN",
"first_name": "ANNETTA",
"middle_name": "J",
"credential": "RD,LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-20",
"last_updated": "2012-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD4032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Defiance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.