Ann Cordum, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M7030 Issued in ID

Practice address

203 W Fort St
Boise, ID 83702-4528

Phone

(208) 994-8656

Fax

(888) 972-4280

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ann Cordum PLLC

  • Internal Medicine Physician
  • Boise, ID
  • NPI 1013383645
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1982653879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W FORT ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024528",
            "telephone_number": "208-994-8656",
            "fax_number": "888-972-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W FORT ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024528",
            "telephone_number": "208-994-8656",
            "fax_number": "888-972-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDUM",
        "first_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M7030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse George Cops, ATC, LAT
• Coralvita Boise, LLC
• Carolyn Corbett, N.P.
• Heather Rae Corder, COTA/L
• Erin Cordova
• Nic R Cordum, M.D.
• Michael Corey
• Briana Marie Corkill, MD
• Kerri Corlett
• Carol M Cornelius, PHARMD, RPH

• Internal Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.