NPIMap

Individual provider Active NPI

Geoffrey Dee Cornelsen, D.O.

  • Orthopaedic Surgery Physician
  • Show Low, AZ
National Provider Identifier
1447415161
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
006377 Issued in AZ
Practice address
4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827
Phone
(928) 537-6700
Fax
(928) 532-2157
NPI assigned
Jul 22, 2008
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X OS015070 PA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 56152 MN
Orthopaedic Surgery Physician 207X00000X OT012680 PA
Orthopaedic Surgery Physician 207X00000X 006377 AZ Primary

Addresses

Primary practice location

4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827

Mailing address

4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827
Phone (928) 537-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20140814002691 AZ Practitioner - Orthopedic Surgery 6305073370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4951 S White Mountain Rd
BLDG a
Show Low, AZ 85901-7801
Phone (928) 537-6700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement16
Knee replacement13
Lower limb (leg) arthroscopy (minimally invasive joint repair)17
Upper limb (arm) arthroscopy (minimally invasive joint repair)30
Removal of tissue19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT012680PAMDOrthopaedic Surgery Physician
006377AZMDSports Medicine (Orthopaedic Surgery) Physician
OS015070PAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kingman Healthcare, Inc Current Accepting new patients
Summit Healthcare Medical Associates CurrentSince Dec 1, 2019 Accepting new patients
Kingman Healthcare, Inc Orthopaedic Surgery CurrentSince Jul 1, 2014 Accepting new patients
Summit Healthcare Medical Associates CurrentSince Dec 1, 2019 Accepting new patients
Kingman Healthcare, Inc CurrentSince Jul 1, 2014 Accepting new patients
Summit Healthcare Association Current Accepting new patients
Summit Healthcare Association Past Accepting new patients

Locations

1739 E Beverly Ave
Ste 102
Kingman, AZ 86409
Phone (928) 681-8693

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

4951 S White Mountain Rd
Show Low, AZ 85901
Phone (928) 532-5848

4951 S White Mountain Rd
Bldg A
Show Low, AZ 85901
Phone (928) 537-6700

1121 S Main St
Snowflake, AZ 85937
Phone (928) 532-3008

Interoperability endpoints

  • Direct secure messaging: geofferycornelsen@shrmcshma.allscriptsdirect.net

Organizations & group practices 7

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 5

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": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1447415161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 S WHITE MOUNTAIN RD BLDG A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017827",
            "telephone_number": "928-537-6700",
            "fax_number": "928-532-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 S WHITE MOUNTAIN RD BLDG A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017827",
            "telephone_number": "928-537-6700",
            "fax_number": "928-532-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELSEN",
        "first_name": "GEOFFREY",
        "middle_name": "DEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "PA",
            "license": "OS015070",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "56152",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OT012680",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "006377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.