Individual provider Active NPI

Julie Cornell, CRNA

  • Certified Registered Nurse Anesthetist
  • Canton, OH
National Provider Identifier
1124082045
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA02890NA Issued in OH
Practice address
2600 6TH St SW
Ohio Hospital Based Physician Corp
Canton, OH 44710
Phone
(330) 363-7462
Fax
(330) 363-7679
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X COA02890NA OH Primary

Addresses

Primary practice location

2600 6TH St SW
Ohio Hospital Based Physician Corp
Canton, OH 44710

Mailing address

2600 6TH St SW
Ohio Hospital Based Physician Corp
Canton, OH 44710
Phone (330) 363-7462

Other identifiers 1

IdentifierTypeStateIssuer
0789115MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081216000191 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466514054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.19 of 100Reported as group
Quality
63.25
Promoting interoperability
98
Improvement activities
40
Cost
72.4

Merit-based Incentive Payment System (MIPS)

Final score
85.62 of 100Reported as group
Quality
77.5
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
COA02890NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Aultman Deuble Heart & Vascular Hospital, LLC CurrentSince Jan 6, 2020 Accepting new patients
Barrett Pain Associates, Inc PastSince Sep 1, 2007 Accepting new patients
Anesthesia Care of Union Hospital, Inc. PastSince Aug 1, 2005 Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

2600 6th St SW
Ste A2800
Canton, OH 44710

659 Boulevard St
Dover, OH 44622
Phone (330) 343-3311

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1124082045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 6TH ST SW",
            "address_2": "OHIO HOSPITAL BASED PHYSICIAN CORP",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44710",
            "telephone_number": "330-363-7462",
            "fax_number": "330-363-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 6TH ST SW",
            "address_2": "OHIO HOSPITAL BASED PHYSICIAN CORP",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44710",
            "telephone_number": "330-363-7462",
            "fax_number": "330-363-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "JULIE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA02890NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0789115",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.