Individual provider Active NPI

James Joseph Corneiller, D.C.

  • Chiropractor
  • Eau Claire, WI
National Provider Identifier
1376684860
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3871-012 Issued in WI
Practice address
2811 E Hamilton Ave
Eau Claire, WI 54701-6863
Phone
(715) 831-8535
NPI assigned
Feb 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3871-012 WI Primary

Addresses

Primary practice location

2811 E Hamilton Ave
Eau Claire, WI 54701-6863

Mailing address

2811 E Hamilton Ave
Eau Claire, WI 54701-6863
Phone (715) 831-8535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120502000375 WI Practitioner - Chiropractic 7810159175 Practice locations: Eau Claire, WI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2811 E Hamilton Ave
Eau Claire, WI 54701-6863
Phone (715) 831-8535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3871-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Corneiller Chiropractic PastSince Dec 1, 2002 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376684860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 E HAMILTON AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016863",
            "telephone_number": "715-831-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 E HAMILTON AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016863",
            "telephone_number": "715-831-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEILLER",
        "first_name": "JAMES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3871-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.