DR. KENNETH JOSEPH CORCORAN (NPI# 1508075334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508075334 |
| Entity Type | Individual |
| Full Name | DR. KENNETH JOSEPH CORCORAN |
| Credential | PT, DPT, SCS |
| Practice Address |
2826 Randolph Rd Charlotte NC 28211-1386 |
| Mailing Address |
Po Box 12512 Charlotte NC 28220-2512 |
| Practice Telephone | 7168304866 |
| Mailing Telephone | 7168304866 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2018-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
18323 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251S0007X |
Physical Therapist Specialization: Sports |
029027-1 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251S0007X |
Physical Therapist Specialization: Sports |
40QA01368400 | NJ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | LICENSE NUMBER | 029027-1 | 01 |
| NC | LICENSE NUMBER | 18323 | 01 |
| NJ | LICENSE NUMBER | 40QA01368400 | 01 |
| Street Address |
2826 RANDOLPH RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28211-1386 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588660716 | Glenn Bradford Perry | Orthopaedic Surgery | 2826 Randolph Rd, Charlotte, NC 28211-1019 | 2005-06-22 |
| 1942858733 | Jonathan Oakes | Physician Assistant | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2019-08-27 |
| 1083127419 | Jodi Ann Arreguin | Physician Assistant | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2017-11-07 |
| 1659819126 | Lauren Scollin | Physical Therapist | 2826 Randolph Rd, 2nd Floor, Charlotte, NC 28211-1386 | 2017-02-06 |
| 1538601695 | Chelsea Parker | Physical Therapist | 2826 Randolph Rd, 2nd Floor, Charlotte, NC 28211-1386 | 2016-11-07 |
| 1437605169 | Select Physical Therapy | Clinic/Center | 2826 Randolph Rd, 2nd Floor, Charlotte, NC 28211 | 2016-09-01 |
| 1861945156 | Justin R.n. Kocan | Physical Therapist | 2826 Randolph Rd, 2nd Floor, Charlotte, NC 28211-1386 | 2016-08-03 |
| 1265771505 | Kristine Ann Pumpa | Physical Therapist | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2013-02-06 |
| 1043581754 | Jeffrey Bennett | Specialist/Technologist | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2012-01-26 |
| 1306116421 | John Ryan Maynard | Physician Assistant | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2012-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
| 1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
| 1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
| 1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
| 1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
| 1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
| 1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
| 1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
| Find all providers in zip 28211 | ||||
| Taxonomy Code | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629499181 | Karon Williams | Physical Therapist | 5801 Rupert Ln, Charlotte, NC 28215-2347 | 2013-12-30 |
| 1871084392 | Christopher Cox | Physical Therapist | 8918 Blakeney Professional Dr, Charlotte, NC 28277-6691 | 2018-05-21 |
| 1093103970 | Pulse Sport Wear Inc | Physical Therapist | 818 Friendly Pl, Charlotte, NC 28213-5800 | 2014-12-31 |
| 1598997751 | Timothy William Jackson | Physical Therapist | 8918 Blakeney Professional Dr, Suite 120, Charlotte, NC 28277-6691 | 2009-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1760923775 | Thomas Moore II | Physical Therapist | 5100 Paschall Dr, Durham, NC 27705-8534 | 2017-03-10 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1154730992 | Niles Fleet | Physical Therapist | Wingate Rd., Reynolds Gymnasium Room 106, Winston Salem, NC 27106 | 2014-08-06 |
| 1588940381 | James Edward Fernandes | Physical Therapist | Finch Yeager Building, Durham, NC 27710-0001 | 2011-10-25 |
| 1740466721 | Kyndall L Boyle | Physical Therapist | 719-a Greenway Rd #29, Suites 207 & 209, Boone, NC 28607 | 2008-01-21 |
| 1215135975 | Nicholas Daniel Potter | Physical Therapist | 118 Cameron Indoor Stadium, Box 90555, Durham, NC 27708-0001 | 2007-07-04 |
| 1356419360 | Carrie Ann Rubertino Shearer | Physical Therapist | 320 Emergency Room Dr, James A. Taylor Building Cb#7470, Chapel Hill, NC 27599-7470 | 2006-11-30 |
| 1942389861 | Todd Allen Watson | Physical Therapist | 1390 Sand Hill Rd, Suite 1, Candler, NC 28715-8938 | 2006-11-02 |
| 1285710145 | James Reece Scifers | Physical Therapist | 135 Moore Hall, Cullowhee, NC 28723 | 2006-10-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.