Organization Active NPI

Cornerstone Direct Care, LLC

  • Gerontology Nurse Practitioner
  • Cullman, AL
National Provider Identifier
1558055939
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Legal business name
CORNERSTONE DIRECT CARE, LLC
Practice address
320 County Road 676
Cullman, AL 35055-7009
Phone
(256) 339-0901
Fax
(256) 419-2386
NPI assigned
Jun 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Authorized official

Name
Chris Williams, NP
Title
Owner
Phone
(256) 339-0901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X Primary

Addresses

Primary practice location

320 County Road 676
Cullman, AL 35055-7009

Mailing address

320 County Road 676
Cullman, AL 35055-7009
Phone (256) 339-0901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230628000739 AL Part B Supplier - Clinic/Group Practice 1557729209 Receives reassigned benefits from 2 practitioners
Practice locations: Cullman, AL

National Provider Directory

National Provider Directory

Locations

2712 Washington St
Alexander City, AL 35010

105 Michelle St NW
Hanceville, AL 35077

1100 2nd Ave E
Oneonta, AL 35121
Phone (205) 255-3828

520 Lasalle St
Rainbow City, AL 35906

Practitioners & affiliated clinicians

Practitioners 2

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": "1686096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1558055939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 COUNTY ROAD 676",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350557009",
            "telephone_number": "256-339-0901",
            "fax_number": "256-419-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 COUNTY ROAD 676",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350557009",
            "telephone_number": "256-339-0901",
            "fax_number": "256-419-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE DIRECT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-339-0901",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.