Pamela S Cornwell, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71010035A Issued in IN

Practice address

7411 Hope Dr
Fort Wayne, IN 46815-5687

Phone

(260) 264-5600

Fax

(260) 444-2082

NPI assigned

Feb 19, 2015

Last updated

Apr 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pcornwell@direct.iuhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Hanover, IN
  • NPI 1649770769
  Medicare reassignment NPD
• FC Indiana, LLC

  dba First Care Clinics

  • Nurse Practitioner
  • Bedford, IN
  • NPI 1225579063
  Medicare reassignment NPD
• Indiana University Health Urgent Care Centers, LLC.

  dba IU Health Urgent Care LLC

  • Urgent Care Clinic/Center
  • Greenwood, IN
  • NPI 1750763819
  Medicare reassignment NPD
• Lifespring, Inc

  dba Southern Indiana Mental Health and Guidance Center of ECI

  • Community/Behavioral Health Agency
  • Jeffersonville, IN
  • NPI 1851489942
  Medicare reassignment NPD
• FC Indiana, LLC

  • Rural Health Clinic/Center
  • Bedford, IN
  • NPI 1841911591
  NPD
• Indiana University Health Urgent Care Centers, LLC

  dba IU Health Urgent Care Centers, LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1972273654
  NPD
• Lifespring, Inc

  dba LifeSpring Health Systems

  • Community/Behavioral Health Agency
  • Dale, IN
  • NPI 1639029283
  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Pace Community Action Agency, Inc.

  • Ambulatory Family Planning Facility
  • Vincennes, IN
  • NPI 1962575423
  NPD (past)

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1558753152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 HOPE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468155687",
            "telephone_number": "260-264-5600",
            "fax_number": "260-444-2082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Wabash Ave",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "475913216",
            "country_code": "US",
            "telephone_number": "812-882-6069",
            "fax_number": "812-886-5307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "PAMELA",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-19",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010035A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28150677A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100155290",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcornwell@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7411 Hope Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468155687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cornerstone Caregiving East LLC (Cornerstone Caregiving)
• Cornerstone Counseling & Consulting, P.C,
• Justin Robert Cornewell, PHARMD
• Kimberly Paige Cornman, MA, BCBA
• Carissa Cornwall, RBT
• Gina Coronato
• Kit J Corps, MA, LMHCA
• Leo J Corral, LAT, ATC
• Angeleah Corrales
• Spencer Phillip Corrona, DC

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.