Active NPI
Rachael D Cornutt, LPN
- Licensed Practical Nurse
- Eugene, OR
National Provider Identifier
1114506896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 201701354LPN
- Practice address
- 1654 N Danebo Ave
Eugene, OR 97402-6416 - Phone
- (541) 515-5060
- NPI assigned
- Apr 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 201701354LPN | OR | Primary |
Addresses
Primary practice location
1654 N Danebo Ave
Eugene, OR 97402-6416
Mailing address
1654 N Danebo Ave
Eugene, OR 97402-6416
Phone (541) 515-5060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201701354LPN | Other | OR | OREGON STATE BOARD OF NURSING |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 201701354LPN | OR | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617753600000",
"number": "1114506896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1654 N DANEBO AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974026416",
"telephone_number": "541-515-5060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1654 N DANEBO AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974026416",
"telephone_number": "541-515-5060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNUTT",
"first_name": "RACHAEL",
"middle_name": "D",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-07",
"last_updated": "2021-04-07",
"certification_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OR",
"license": "201701354LPN",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON STATE BOARD OF NURSING",
"identifier": "201701354LPN",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.