Jan Gordon Cornell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35.129685 Issued in OH

Practice address

1431 Wayne Ave
Dayton, OH 45410-1411

Phone

(937) 348-7001

Fax

(937) 949-6113

NPI assigned

Dec 15, 2006

Last updated

Mar 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Family Practice

Education

University of Kentucky College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osh-Oh Physicians Group PCGroup PAC ID 1759639693, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osh-Oh Physicians Group PC

  dba OSH-OH Physicians Group, LLC

  • Primary Care Clinic/Center
  • Cleveland, OH
  • NPI 1346747946

  Family Medicine

  Medicare reassignment Care Compare group NPD

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

• Fidelity Health Care Inc

  dba Fidelity Nursing Systems

  • Home Health Agency
  • Moraine, OH
  • NPI 1235127838
  Care Compare affiliation
• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1306908132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746071",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746071",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 WAYNE AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454101411",
            "telephone_number": "937-348-7001",
            "fax_number": "937-949-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "JAN",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01070166 A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.129685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201035040",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067258",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Jo Corey, P.T.
• Skylar Corey
• Savanna Cahoon Corless, MD
• Dashanay Corley
• Katrina L Corn
• Cornerstone Caregiving East LLC
• Cornerstone Foot and Ankle Inc
• Cornerstone Project
• Cornerstone Project LLC
• Cornerstone Project, LLC

• Family Medicine Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.