Active NPI
Jessica Braun Cornman, DPT
- Physical Therapist
- Charlotte, NC
National Provider Identifier
1174929293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15205
- Practice address
- 10516 Park Rd
Charlotte, NC 28210-8405 - Phone
- (704) 541-9080
- NPI assigned
- Nov 17, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT28486 | FL | |
| Physical Therapist | 225100000X | 15205 | NC | Primary |
Addresses
Primary practice location
10516 Park Rd
Charlotte, NC 28210-8405
Mailing address
10516 Park Rd
Charlotte, NC 28210-8405
Phone (704) 541-9080
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 |
|---|---|---|---|
| 15205 | NC | MD | Pharmacist |
| PT28486 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437004800000",
"number": "1174929293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10516 PARK RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282108405",
"telephone_number": "704-541-9080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10516 PARK RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282108405",
"telephone_number": "704-541-9080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNMAN",
"first_name": "JESSICA",
"middle_name": "BRAUN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-17",
"last_updated": "2015-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT28486",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "15205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.