Corbin Lee Allred, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Provo, UT
NPI 1952944993 · NPPES record last updated Jan 3, 2023
Key facts
- NPI
- 1952944993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 9594970-4405 (UT)
- Practice address
- 75 S 200 E
Provo, UT 84606-3146 - Phone
- (801) 375-2207
- Fax
- (801) 375-2307
- NPI assigned
- Oct 22, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200312002142 | UT | Practitioner - Nurse Practitioner | 7113355785 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clanton Enterprises, Series LLC | Current |
Accepting new patients | |
| Hofmann Arthritis Institute, PLLC | Past |
Accepting new patients |
Locations
560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600
75 S 200 E
Ste 202
Provo, UT 84606
Phone (801) 375-2207
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9594970-4405 | UT | Yes |
Addresses
Primary practice location
75 S 200 E
Provo, UT 84606-3146
Mailing address
75 S 200 E
Provo, UT 84606-3146
Phone (801) 375-2207
Other providers in Provo, UT
- Tyler Clyff Allen
- Haley Allmendinger
- Amelia Ngahuia Allred
- Aspen Kay Allred
- Carl Dain Allred
- Emily Allred
- Hailey Grace Allred
- Jentrie Tessa Allred
- Jeremy Glade Allred
- Tabatha Rose Allred
All providers in Provo, UT · Family Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.