Individual provider Active NPI

Warren Scott Cornwell, B.S.

  • Physical Therapist
  • Fresno, CA
National Provider Identifier
1043540693
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT23371 Issued in CA
Practice address
7265 N 1St St
#103
Fresno, CA 93720-2956
Phone
(559) 438-5489
NPI assigned
Jan 4, 2010
Last updated
Jan 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT23371 CA Primary

Addresses

Primary practice location

7265 N 1St St
#103
Fresno, CA 93720-2956

Mailing address

7265 N 1St St
#103
Fresno, CA 93720-2956
Phone (559) 438-5489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230804003311 CA Practitioner - Physical Therapist in Private Practice 8022479195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
PT23371CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JBJC Inc. Physical Therapist CurrentSince Sep 10, 2024 Accepting new patients
Spitzers Physical Therapy and Personal Training Center, Inc. Physical Therapist CurrentSince Jul 10, 2023 Accepting new patients
JBJC Inc CurrentSince Sep 10, 2024 Accepting new patients

Locations

615 4th St
Clovis, CA 93612
Phone (559) 322-5345

1073 E Shaw Ave
Fresno, CA 93710
Phone (559) 227-4440

524 S Clovis Ave
Ste I
Fresno, CA 93727
Phone (559) 322-5345

534 E Pine St
Ste A
Stockton, CA 95204
Phone (209) 463-5800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1043540693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7265 N 1ST ST",
            "address_2": "#103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202956",
            "telephone_number": "559-438-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7265 N 1ST ST",
            "address_2": "#103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202956",
            "telephone_number": "559-438-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "WARREN",
        "middle_name": "SCOTT",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.