John Wallace Cornwall, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

124680 Issued in NY

Practice address

55 Central Park W # 1-DB
New York, NY 10023-6003

Phone

(212) 799-0630

Fax

(212) 799-4266

NPI assigned

Oct 16, 2006

Last updated

Mar 19, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: john.cornwall@702.chartlogic.direct-ci.com

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1174613400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CENTRAL PARK W # 1-DB",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236003",
            "telephone_number": "212-799-0630",
            "fax_number": "212-799-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CENTRAL PARK W # 1-DB",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236003",
            "telephone_number": "212-799-0630",
            "fax_number": "212-799-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWALL",
        "first_name": "JOHN",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "124680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Kyle Yu Cornico, PHARMD
• Miguel Cornico, CRNA
• Michael James Corning, LMSW
• Andrew Erickson Cornish, MD
• James William Cornwall, MD
• Macintosh Grant Cornwell
• Melinda Cornwell, PH.D.
• Stephanie Cornwell
• Alexandra Jamie Coromilas, MD
• Ellie Jean Coromilas, MD

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.