Provider Demographics
NPI:1316978513
Name:ROMINGER, COREY R (PA-C)
Entity type:Individual
Prefix:MR
First Name:COREY
Middle Name:R
Last Name:ROMINGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 US HIGHWAY 2 W STE B
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3499
Mailing Address - Country:US
Mailing Address - Phone:406-630-6755
Mailing Address - Fax:
Practice Address - Street 1:1325 US HIGHWAY 2 W STE B
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3499
Practice Address - Country:US
Practice Address - Phone:406-630-6755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-160596363A00000X
VA0110002117363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010249660Medicaid