NPIMap

Individual provider Active NPI

Frank Anthony Cornella, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Springfield, MO
National Provider Identifier
1356322838
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
015798 Issued in MO
Practice address
3237 E Sunshine St
Springfield, MO 65804-6919
Phone
(417) 881-4546
Fax
(417) 883-0443
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 114534 MO
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 015798 MO Primary

Addresses

Primary practice location

3237 E Sunshine St
Springfield, MO 65804-6919

Mailing address

3237 E Sunshine St
Springfield, MO 65804-6919
Phone (417) 881-4546

Other identifiers 2

IdentifierTypeStateIssuer
209802610MedicaidMO
409802618MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000091 MO Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 9739107947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Univ of Calif, Los Angeles School of Dentistry, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3237 E Sunshine St B
Oral Surgery of Springfield
Springfield, MO 65804-6919
Phone (417) 881-4546

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015798MOMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Advocates for a Healthy Community, Inc CurrentSince Feb 1, 2018 Accepting new patients
Advocates for a Healthy Community Inc CurrentSince Feb 1, 2018 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

440 E Tampa St
Springfield, MO 65806
Phone (417) 831-0191

Interoperability endpoints

  • Direct secure messaging: frank.cornella.p1@direct.jordanvalley.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 12

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1356322838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3237 E SUNSHINE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046919",
            "telephone_number": "417-881-4546",
            "fax_number": "417-883-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 E SUNSHINE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046919",
            "telephone_number": "417-881-4546",
            "fax_number": "417-883-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELLA",
        "first_name": "FRANK",
        "middle_name": "ANTHONY",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "114534",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "015798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209802610",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409802618",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.