Olivia Rae Cornelius

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-233860 Issued in TX

Practice address

220 N Park Blvd Ste 112
Grapevine, TX 76051-6900

Phone

(817) 796-6860

Fax

(817) 796-2895

NPI assigned

Sep 30, 2022

Last updated

Sep 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1497479752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N PARK BLVD STE 112",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760516900",
            "telephone_number": "817-796-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N PARK BLVD STE 112",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760516900",
            "telephone_number": "817-796-6860",
            "fax_number": "817-796-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "OLIVIA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "RBT-22-233860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tommie Lynn Cook, M.S., RPH
• Troy William Cook, D.C.
• Anna Grace Cool, PA-C
• Lisa Marie Cooper, RDH,BS
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• Kathleen Dawn Cortelyou
• Ericka Lynda Cortez, LMT, MI
• Corvinus Medical Group LLC
• Patricia A Covey, P.T.
• Alan E Cowen, MD

• Behavior Technician in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Behavior Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.