Organization Active NPI

David H. Cornell, M.D., LLC

  • Specialist
  • Atlanta, GA
National Provider Identifier
1487938924
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
31897 Issued in GA
Legal business name
DAVID H. CORNELL, M.D., LLC
Practice address
993 Johnson Ferry Rd NE
Suite C225
Atlanta, GA 30342-1620
Phone
(404) 255-2855
Fax
(404) 255-1284
NPI assigned
Oct 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Authorized official

Name
David Cornell, M.D.NPI 1831297225
Title
Owner
Phone
(404) 255-2855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 31897 GA Primary

Addresses

Primary practice location

993 Johnson Ferry Rd NE
Suite C225
Atlanta, GA 30342-1620

Mailing address

993 Johnson Ferry Rd NE
Suite C225
Atlanta, GA 30342-1620
Phone (404) 255-2855

Other identifiers 1

IdentifierTypeStateIssuer
1831297225OtherGANPI (TYPE 1)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111004000301 GA Part B Supplier - Clinic/Group Practice 1951573575 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

993 Johnson Ferry Rd
Ste C225
Sandy Springs, GA 30342
Phone (404) 255-2855

993 Johnson Ferry Rd
Ste 225
Sandy Springs, GA 30342

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1487938924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "993 JOHNSON FERRY RD NE",
            "address_2": "SUITE C225",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421620",
            "telephone_number": "404-255-2855",
            "fax_number": "404-255-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "993 JOHNSON FERRY RD NE",
            "address_2": "SUITE C225",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421620",
            "telephone_number": "404-255-2855",
            "fax_number": "404-255-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID H. CORNELL, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-255-2855",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "31897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (TYPE 1)",
            "identifier": "1831297225",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.