Individual provider Active NPI

Janelle M Cornforth, NP

  • Nurse Practitioner
  • Stevensville, MI
National Provider Identifier
1558801068
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704153804 Issued in MI
Practice address
5515 Cleveland Ave
Stevensville, MI 49127-9670
Phone
(269) 429-1499
Fax
(269) 429-4002
NPI assigned
Mar 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704153804 MI Primary

Addresses

Primary practice location

5515 Cleveland Ave
Stevensville, MI 49127-9670

Mailing address

5515 Cleveland Ave
Stevensville, MI 49127-9670
Phone (269) 429-1499

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170518001510 MI Practitioner - Nurse Practitioner 5890062012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

5515 Cleveland Ave
Suite 1
Stevensville, MI 49127-9670
Phone (269) 429-6604

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet Current Accepting new patients
Lakeland Medical Practices CurrentSince May 1, 2017 Accepting new patients
Lakeland Medical Practices CurrentSince May 1, 2017 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Dec 22, 2022 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Mar 1, 2023 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Dec 22, 2022 Accepting new patients

Locations

2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

5515 Cleveland Ave
Ste 1
Stevensville, MI 49127
Phone (269) 429-6604

5515 Cleveland Ave
Stevensville, MI 49127
Phone (269) 429-9644

5515 Cleveland Ave
Ste 5
Stevensville, MI 49127
Phone (269) 429-9644

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

Interoperability endpoints

  • Direct secure messaging: jcornforth1268994@epic00.corewelldirect.org
  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1558801068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-1499",
            "fax_number": "269-429-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-1499",
            "fax_number": "269-429-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNFORTH",
        "first_name": "JANELLE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704153804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MI

Sources for this page

Verify at the official NPI Registry.