Derok S Cornwell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

100 Medical Center Dr
Suite 101
Gadsden, AL 35903-1130

Phone

(256) 492-8590

Fax

(256) 492-4498

NPI assigned

Mar 14, 2006

Last updated

Oct 24, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: derok.cornwell.1@2264.direct.athenahealth.com

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1174591366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "address_2": "SUITE 101",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031130",
            "telephone_number": "256-492-8590",
            "fax_number": "256-492-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "address_2": "SUITE 101",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031130",
            "telephone_number": "256-492-8590",
            "fax_number": "256-492-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "DEROK",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA- 885",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Core ENT. LLC
• Thomas R Corley, MD
• Cornerstone Pathology, P.C.
• Ashley Miller Cornutt, C.R.N.A.
• Wayne F Cornutt, R.PH.
• Corporate Health Dimensions, Inc. (Goodyear Family Pharmacy)
• Corporate Pharmacy Services Inc
• Corporate Pharmacy Services Inc
• Chris Mark Coshatt, DMD
• Hannah Beth Couch

• Physician Assistant in Gadsden, AL
• Providers in Gadsden, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.