Individual provider Active NPI

George Willett Cornell, MD

  • Gynecology Physician
  • Suffolk, VA
National Provider Identifier
1003879370
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
0101021787 Issued in VA
Practice address
2000 Meade Parkway
Suffolk, VA 23434-4259
Phone
(757) 539-0251
Fax
(757) 539-7523
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 0101021787 VA Primary

Addresses

Primary practice location

2000 Meade Parkway
Suffolk, VA 23434-4259

Mailing address

PO Box 7068
Portsmouth, VA 23707-0068
Phone (757) 686-3508

Other identifiers 3

IdentifierTypeStateIssuer
8905375MedicaidNC
160010030OtherVARAILROAD MEDICARE
6260152MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Medical Center, Inc Current Accepting new patients
Bayview Physician Services, PC Current Accepting new patients

Locations

154 Burnetts Way
Ste 101
Suffolk, VA 23434
Phone (757) 216-4030

2000 Meade Pkwy
Suffolk, VA 23434
Phone (757) 539-0251

1708 Old Donation Pkwy
Virginia Beach, VA 23454
Phone (757) 395-5300

Interoperability endpoints

  • Direct secure messaging: georgecornell@lmcva.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/8454/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1003879370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7068",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070068",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEADE PARKWAY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344259",
            "telephone_number": "757-539-0251",
            "fax_number": "757-539-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "GEORGE",
        "middle_name": "WILLETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "VA",
            "license": "0101021787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8905375",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160010030",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6260152",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.