Individual provider Active NPI

Kathryn Calhoun Cornelius, MD

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1255710679
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R0845 Issued in TX
Practice address
3600 Gaston Ave Ste 755
Dallas, TX 75246-1907
Phone
(214) 823-4200
NPI assigned
May 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X R0845 TX Primary

Addresses

Primary practice location

3600 Gaston Ave Ste 755
Dallas, TX 75246-1907

Mailing address

3600 Gaston Ave Ste 755
Dallas, TX 75246-1907
Phone (214) 823-4200

Other names 1

  • Dr. Kathryn Ann Calhoun Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180712002735 TX Practitioner - Family Practice 3375899883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Andrew Chung, M.D. PLLCGroup PAC ID 6608991989, 5 clinicians

Practice addresses (Care Compare)

3600 Gaston Ave
Suite 755
Dallas, TX 75246-1907
Phone (214) 823-4200

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Texas Health Presbyterian Hospital Dallas Hospital, Dallas, TX, CCN 450462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Chung MD PLLC Single Specialty CurrentSince Sep 1, 2018 Accepting new patients
Vesta Solutions Group, LLC Single Specialty PastSince May 21, 2014 Accepting new patients

Locations

3600 Gaston Ave
Ste 703
Dallas, TX 75246
Phone (214) 823-4200

3600 Gaston Ave
Ste 755
Dallas, TX 75246
Phone (214) 823-4200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDADBA
  • Direct secure messaging: kathryn.cornelius@acmp.eclinicaldirectplus.com

Organizations & group practices 2

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1255710679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE STE 755",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461907",
            "telephone_number": "214-823-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE STE 755",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461907",
            "telephone_number": "214-823-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "KATHRYN",
        "middle_name": "CALHOUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R0845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "CALHOUN",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.