Active NPI
Michelle Cornelius
- Clinical Social Worker
- Tuscumbia, AL
National Provider Identifier
1356818231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4216C
- Practice address
- 234 Keller Park Blvd
Tuscumbia, AL 35674-1417 - Phone
- (256) 381-6963
- Fax
- (256) 381-6018
- NPI assigned
- Oct 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4216C | AL | Primary |
Addresses
Primary practice location
234 Keller Park Blvd
Tuscumbia, AL 35674-1417
Mailing address
234 Keller Park Blvd
Tuscumbia, AL 35674-1417
Phone (256) 381-6963
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7688 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tennessee Valley Pediatric Associatesinc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Tuscumbia, AL
- NPI 1043323439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540771200000",
"number": "1356818231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "234 KELLER PARK BLVD",
"city": "TUSCUMBIA",
"state": "AL",
"postal_code": "356741417",
"telephone_number": "256-381-6963",
"fax_number": "256-381-6018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 KELLER PARK BLVD",
"city": "TUSCUMBIA",
"state": "AL",
"postal_code": "356741417",
"telephone_number": "256-381-6963",
"fax_number": "256-381-6018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNELIUS",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-29",
"last_updated": "2018-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AL",
"license": "4216C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuscumbia, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.