Individual provider Active NPI

Hugh Colby Cornelson, FNP-C

  • Family Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1053899682
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP230883 Issued in GA
Practice address
655 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3756
Phone
(770) 532-7092
Fax
(770) 536-0383
NPI assigned
Aug 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP230883 GA Primary
Registered Nurse First Assistant 163WR0006X RN230883 GA

Addresses

Primary practice location

655 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3756

Mailing address

PO Box 658
Gainesville, GA 30503-0658
Phone (770) 718-1122

Other practice location 1

1270 Friendship Rd
Braselton, GA 30517-5608
Phone (678) 207-4477

Other practice location 2

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 532-7092

Other practice location 3

1400 River Place
Braselton, GA 30517-5600
Phone (770) 532-7092

Other practice location 4

1524 River Place
Suite 100
Braselton, GA 30517-5614
Phone (678) 207-4477

Other practice location 5

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 532-7092

Other practice location 6

835 Austin Dr
Demorest, GA 30535-4513
Phone (706) 754-8518

Other practice location 7

801 Austin Dr
Demorest, GA 30535-4513
Phone (706) 754-8066

Other identifiers 9

IdentifierTypeStateIssuer
003208648EMedicaidGA
06083704OtherGAAMERIGROUP
003208648AMedicaidGA
003208648BMedicaidGA
003208648GMedicaidGA
003208648FMedicaidGA
003208648CMedicaidGA
003208648DMedicaidGA
1710460OtherGAWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181113003452 GA Practitioner - Nurse Practitioner 2062766827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians
Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

1270 Friendship Rd
Braselton, GA 30517-5608
Phone (770) 533-6511

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 297-5700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.1 of 100Reported as group
Quality
87.6
Promoting interoperability
100
Improvement activities
40
Cost
76.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP230883GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Longstreet Clinic, PC CurrentSince Aug 1, 2018 Accepting new patients
Southern Surgical Assistants, LLC CurrentSince Jan 23, 2019 Accepting new patients
The Longstreet Clinic PC CurrentSince Aug 1, 2018 Accepting new patients
Southern Surgical Assistants LLC Past Accepting new patients

Locations

1524 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 532-7092

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

1270 Friendship Rd
Braselton, GA 30517
Phone (678) 207-4200

801 Austin Dr
Demorest, GA 30535
Phone (706) 754-8066

835 Austin Dr
Demorest, GA 30535
Phone (706) 754-8518

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

655 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 535-9391

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 297-2200

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1053899682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013756",
            "telephone_number": "770-532-7092",
            "fax_number": "770-536-0383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1270 Friendship Rd",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175608",
            "country_code": "US",
            "telephone_number": "678-207-4477",
            "fax_number": "678-207-4478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "743 Spring St NE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013715",
            "country_code": "US",
            "telephone_number": "770-532-7092",
            "fax_number": "770-536-0383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 River Place",
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            "country_code": "US",
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            "fax_number": "770-536-0383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
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            "address_2": "Suite 100",
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            "postal_code": "305175614",
            "country_code": "US",
            "telephone_number": "678-207-4477",
            "fax_number": "678-207-4478",
            "country_name": "United States",
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        },
        {
            "address_1": "725 Jesse Jewell Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013834",
            "country_code": "US",
            "telephone_number": "770-532-7092",
            "fax_number": "770-534-8145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "835 Austin Dr",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "305354513",
            "country_code": "US",
            "telephone_number": "706-754-8518",
            "fax_number": "706-754-6238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Austin Dr",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "305354513",
            "country_code": "US",
            "telephone_number": "706-754-8066",
            "fax_number": "706-754-8086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELSON",
        "first_name": "HUGH",
        "middle_name": "COLBY",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-06",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP230883",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "GA",
            "license": "RN230883",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208648E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "06083704",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208648A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208648B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208648G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208648F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208648C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208648D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1710460",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.