Basic Information
| Provider Information | |||||||||
| NPI: | 1215049242 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORRINGTON | ||||||||
| FirstName: | KIP | ||||||||
| MiddleName: | ALAM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 60447 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282600447 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 7607 NC HIGHWAY 68 N STE B | ||||||||
| Address2: | |||||||||
| City: | OAK RIDGE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273108803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366433378 | ||||||||
| FaxNumber: | 3366433670 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 10/25/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 200000755 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 7471351 | 01 | AETNA | OTHER | P00472868 | 01 | MEDICARE RAILROAD | OTHER | 131W4 | 01 | BCBS | OTHER | 800208 | 01 | PARTNERS | OTHER | 191677 | 01 | MEDCOST | OTHER | 89131W4 | 05 | NC | MEDICAID | 0106804 | 01 | UNITED HEALTHCARE | OTHER | 5831404 | 01 | CIGNA | OTHER |