Jessica M Cornelius, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA515 Issued in KY

Practice address

478 Whirlaway Dr Ste 100
Danville, KY 40422-9037

Phone

(859) 236-6613

Fax

(859) 236-2284

NPI assigned

Sep 15, 2006

Last updated

Oct 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cumberland Family Medical Center Inc

  dba Waynesburg Elementary Healthy Kids Clinic

  • Federally Qualified Health Center (FQHC)
  • Waynesburg, KY
  • NPI 1043741713
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1235235607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-864-1472",
            "fax_number": "270-864-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 WHIRLAWAY DR STE 100",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404229037",
            "telephone_number": "859-236-6613",
            "fax_number": "859-236-2284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Education Way",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "KY",
            "postal_code": "404848411",
            "country_code": "US",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 Danville Ave",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "KY",
            "postal_code": "404841205",
            "country_code": "US",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "93 College St",
            "address_purpose": "LOCATION",
            "city": "Hustonville",
            "state": "KY",
            "postal_code": "404379505",
            "country_code": "US",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Tick Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Waynesburg",
            "state": "KY",
            "postal_code": "404898202",
            "country_code": "US",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Old Fort Rd",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "KY",
            "postal_code": "404848540",
            "country_code": "US",
            "telephone_number": "844-435-0900",
            "fax_number": "270-828-4029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "285 Education Way",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "KY",
            "postal_code": "404848411",
            "country_code": "US",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 Ky Highway 328 W",
            "address_purpose": "LOCATION",
            "city": "Waynesburg",
            "state": "KY",
            "postal_code": "404898205",
            "country_code": "US",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "137 Lancaster St",
            "address_purpose": "LOCATION",
            "city": "Crab Orchard",
            "state": "KY",
            "postal_code": "404199628",
            "country_code": "US",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95000824",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Wellness Medical Associates a PC (Community Wellness Medical Associates, P.S.C.)
• Cortney Renee Conklin, APRN
• Melissa K Conner, MD
• Amanda Mae Cooley, APRN
• Copper Creek Midwifery & Family Practice, LLC
• Bridgette E. Coulter, D.M.D.
• Donald Jeff Covell, M.D.
• Elizabeth Ann Coyle, RPH
• Jordan Brittany Crutchfield, NP
• Crystal Clear Counseling, LLC (Crystal McPherson)

• Physician Assistant in Danville, KY
• Providers in Danville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.