Individual provider Active NPI

Michelle Dawn Cornett

  • Massage Therapist
  • Palm Coast, FL
National Provider Identifier
1073358867
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
76516 Issued in FL
Practice address
2 Office Park Dr Ste a
Palm Coast, FL 32137-3859
Phone
(386) 447-9930
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 76516 FL Primary

Addresses

Primary practice location

2 Office Park Dr Ste a
Palm Coast, FL 32137-3859

Mailing address

2 Office Park Dr Ste a
Palm Coast, FL 32137-3859
Phone (386) 447-9930

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
76516FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness One Chiropractic LLC CurrentSince Jun 30, 2024 Accepting new patients

Locations

2 Office Park Dr
Ste A
Palm Coast, FL 32137
Phone (386) 447-9930

Organizations & group practices 1

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": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1073358867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OFFICE PARK DR STE A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373859",
            "telephone_number": "386-447-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OFFICE PARK DR STE A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373859",
            "telephone_number": "386-447-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNETT",
        "first_name": "MICHELLE",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "76516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.