Individual provider Active NPI

William Gerome Cornelison Jr., RN

  • Infection Control Registered Nurse
  • Albany, NY
National Provider Identifier
1336963776
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infection Control Registered NurseTaxonomy code 163WI0600X
License
516246 Issued in NY
Practice address
75 New Scotland Ave
Albany, NY 12208-3409
Phone
(518) 549-6618
Fax
(518) 549-6611
NPI assigned
Nov 12, 2024
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infection Control Registered Nurse 163WI0600X 516246 NY Primary

Addresses

Primary practice location

75 New Scotland Ave
Albany, NY 12208-3409

Mailing address

123 Fyke Rd
Catskill, NY 12414-5108
Phone (518) 947-8959

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
516246NYMDInfection Control Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1336963776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 FYKE RD",
            "city": "CATSKILL",
            "state": "NY",
            "postal_code": "124145108",
            "telephone_number": "518-947-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083409",
            "telephone_number": "518-549-6618",
            "fax_number": "518-549-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELISON",
        "first_name": "WILLIAM",
        "middle_name": "GEROME",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infection Control",
            "state": "NY",
            "license": "516246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.