Individual provider Active NPI

Wendell Aaron Cornett, COTA

  • Occupational Therapy Assistant
  • Clarksville, TN
National Provider Identifier
1518154913
Registry record updated Sep 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA0000001627 Issued in TN
Practice address
220 Highway 76
Clarksville, TN 37043-4102
Phone
(931) 551-0181
NPI assigned
Sep 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA0000001627 TN Primary

Addresses

Primary practice location

220 Highway 76
Clarksville, TN 37043-4102

Mailing address

1230 Cottonwood Dr
Clarksville, TN 37040-4389
Phone (931) 980-7880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA0000001627TNMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1191024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191024000000",
    "number": "1518154913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 COTTONWOOD DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370404389",
            "telephone_number": "931-980-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HIGHWAY 76",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434102",
            "telephone_number": "931-551-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNETT",
        "first_name": "WENDELL",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-29",
        "last_updated": "2007-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "OTA0000001627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2007; 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.