Individual provider Active NPI

Linsey Lora Cornelius, DMD

  • Pediatric Dentistry
  • Richmond, KY
National Provider Identifier
1548676349
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9459 Issued in KY
Practice address
1012 Ival James Blvd
Richmond, KY 40475-8174
Phone
(859) 626-9620
NPI assigned
Jul 1, 2014
Last updated
Sep 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9459 KY
Pediatric Dentistry 1223P0221X 9459 KY Primary

Addresses

Primary practice location

1012 Ival James Blvd
Richmond, KY 40475-8174

Mailing address

1012 Ival James Blvd
Richmond, KY 40475-8174
Phone (859) 626-9620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191001001527 KY Order and Referring Only - DentistPractitioner - Dentist 9739419979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9459KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1548676349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 IVAL JAMES BLVD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758174",
            "telephone_number": "859-626-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 IVAL JAMES BLVD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758174",
            "telephone_number": "859-626-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "LINSEY",
        "middle_name": "LORA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9459",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "9459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

Verify at the official NPI Registry.