Active NPI
B. Jeanne Cornejo, P.T.
- Pediatric Physical Therapist
- Durham, NC
National Provider Identifier
1134526841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 3911
- Practice address
- 1207 Goldenview CT
Durham, NC 27713-8208 - Phone
- (919) 937-9583
- NPI assigned
- Nov 24, 2014
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 3911 | NC | Primary |
Addresses
Primary practice location
1207 Goldenview CT
Durham, NC 27713-8208
Mailing address
1207 Goldenview CT
Durham, NC 27713-8208
Phone (919) 937-9583
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 |
|---|---|---|---|
| 3911 | NC | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416787200000",
"number": "1134526841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1207 GOLDENVIEW CT",
"city": "DURHAM",
"state": "NC",
"postal_code": "277138208",
"telephone_number": "919-937-9583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1207 GOLDENVIEW CT",
"city": "DURHAM",
"state": "NC",
"postal_code": "277138208",
"telephone_number": "919-937-9583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNEJO",
"first_name": "B. JEANNE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-24",
"last_updated": "2014-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NC",
"license": "3911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.