Carolyn Laurice Jefferson Cornelius, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

12973 Issued in NV

Practice address

3131 La Canada St
Suite 241
Las Vegas, NV 89169-2578

Phone

(702) 693-6870

Fax

(702) 693-6899

NPI assigned

Feb 18, 2009

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

Other names 1

• Dr. Carolyn L Cornelius Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1275772006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2764 N GREEN VALLEY PKWY",
            "address_2": "SUITE 504",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142120",
            "telephone_number": "702-528-1668",
            "fax_number": "702-982-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 LA CANADA ST",
            "address_2": "SUITE 241",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692578",
            "telephone_number": "702-693-6870",
            "fax_number": "702-693-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON CORNELIUS",
        "first_name": "CAROLYN",
        "middle_name": "LAURICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "12973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275772006",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "CORNELIUS",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Claire Jeffe
• Rachel Jefferies
• Cherish Marie Jeffers
• Eva Jeffers
• Jefferson C Yu MD
• Jefferson Family Corporation Inc
• Jefferson Family Corporation, Inc
• Jefferson Holdings
• Angelina Regina Jefferson-Das
• Adrienne Jefferson

• Obstetrics & Gynecology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Obstetrics & Gynecology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.