John Thor Cornelius, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A79957 Issued in CA

Practice address

1400 A St BLDG a
Sacramento, CA 95814-0631

Phone

(916) 440-1500

Fax

(916) 440-1512

NPI assigned

Jan 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 15, 2016 through Mar 15, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• County of Sacramento

  • Radiology Clinic/Center
  • Sacramento, CA
  • NPI 1508936030
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467500751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 H ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958141906",
            "telephone_number": "976-616-5531",
            "fax_number": "916-440-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 A ST BLDG A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958140631",
            "telephone_number": "916-440-1500",
            "fax_number": "916-440-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "JOHN",
        "middle_name": "THOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A79957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry I Corman, M.D.
• Jeanette Alverta Cormier, ASD I
• Monica Louise Cornacchia
• Ramon Cornejo-Salamanca
• Susana M Cornejo, PSY.D.
• Mark Joseph Cornell
• Cornerstone Licensed Clinical Social Worker, Inc.
• Charity Fawn Cornet-Barnhart, ASSOCIATE MFT
• Kalynn Cornet
• Alondra Cornish

• Psychiatry Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychiatry Physician in California

• 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; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.