NPIMap

Organization Active NPI

Cornerstone Medical Rockwall PLLC

  • General Practice Physician
  • Rockwall, TX
National Provider Identifier
1144986936
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CORNERSTONE MEDICAL ROCKWALL PLLC
Practice address
1201 Arista Dr Ste 105
Rockwall, TX 75032-6860
Phone
(469) 987-4416
NPI assigned
Nov 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Authorized official

Name
Mr. Chris Souder
Title
Ceo
Phone
(469) 987-4416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1201 Arista Dr Ste 105
Rockwall, TX 75032-6860

Mailing address

1201 Arista Dr Ste 105
Rockwall, TX 75032-6860
Phone (469) 987-4416

Other names 1

  • Anodyne of Rockwall Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220222002116 TX Part B Supplier - Clinic/Group Practice 8729472402 Receives reassigned benefits from 5 practitioners
Practice locations: Rockwall, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1144986936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 ARISTA DR STE 105",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326860",
            "telephone_number": "469-987-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ARISTA DR STE 105",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326860",
            "telephone_number": "469-987-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE MEDICAL ROCKWALL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "SOUDER",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-987-4416",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anodyne of Rockwall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.