Leslie Andrew Cornett, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN052496 Issued in GA

Practice address

2201 Mount Zion Pkwy
Morrow, GA 30260-3312

Phone

(404) 785-8719

Fax

(404) 785-8730

NPI assigned

Oct 8, 2008

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 8, 2008.

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1568613628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 ROCK PLACE DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874272",
            "telephone_number": "770-413-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 MOUNT ZION PKWY",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302603312",
            "telephone_number": "404-785-8719",
            "fax_number": "404-785-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNETT",
        "first_name": "LESLIE",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN052496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Morrow, GA
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.