Individual provider Active NPI

Vance Lee Cornelison, D. C.

  • Chiropractor
  • Little Rock, AR
National Provider Identifier
1538119227
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1606 Issued in AR
Practice address
11523 Kanis Rd
Suite D
Little Rock, AR 72211-3724
Phone
(501) 221-8640
Fax
(501) 221-4379
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1606 AR Primary

Addresses

Primary practice location

11523 Kanis Rd
Suite D
Little Rock, AR 72211-3724

Mailing address

PO Box 242161
Little Rock, AR 72223-0021
Phone (501) 221-8640

Other identifiers 1

IdentifierTypeStateIssuer
152951718MedicaidAR

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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.

Practice roles

OrganizationSpecialtyStatusNew patients
Co-Lu Inc Chiropractor PastSince Jan 1, 1990 Accepting new patients
Vcell Inc Chiropractor PastSince Jun 1, 2008 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199232000000",
    "number": "1538119227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242161",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722230021",
            "telephone_number": "501-221-8640",
            "fax_number": "501-221-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11523 KANIS RD",
            "address_2": "SUITE D",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113724",
            "telephone_number": "501-221-8640",
            "fax_number": "501-221-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELISON",
        "first_name": "VANCE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2008-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152951718",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.