Kathryn Davenport Cornell, A.P.R.N.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

53-76887-072 Issued in KS

Practice address

122 W Myrtle St
Independence, KS 67301-3317

Phone

(620) 577-4062

Fax

(620) 577-4064

NPI assigned

Aug 18, 2015

Last updated

Nov 20, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

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.

• Coffeyville Regional Medical Center Inc

  • Anesthesiology Physician
  • Coffeyville, KS
  • NPI 1265550891
  Medicare reassignment NPD
• Truhealth, LLC

  • Nurse Practitioner
  • Parsons, TN
  • NPI 1063843951

  KS

  Medicare reassignment NPD
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406

  KS

  Medicare reassignment
• Truhealth of Kansas LLC

  • Nurse Practitioner
  • Franklin, TN
  • NPI 1073404109

  KS

  Medicare reassignment
• Coffeyville Regional Medical Center, Inc

  • Family Medicine Physician
  • Coffeyville, KS
  • NPI 1407147903
  NPD (past)

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1588030134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W LAUREL ST",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673013211",
            "telephone_number": "620-332-3280",
            "fax_number": "620-332-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W MYRTLE ST",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673013317",
            "telephone_number": "620-577-4062",
            "fax_number": "620-577-4064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Coffeyville",
            "state": "KS",
            "postal_code": "673374109",
            "country_code": "US",
            "telephone_number": "620-688-6566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "KATHRYN",
        "middle_name": "DAVENPORT",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-76887-072",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13-102368-072",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yollianna Cole
• Community Health Center of Southeast Kansas, Inc (Community Health Center of Southeast Kansas/Four County Mental Health)
• Community Health Center of Southeast Kansas, Inc.
• Debra M Conrady, RN
• Sandra R Cook, PTA
• Janet Foster Cosgrove
• Counseling Services of Kansas, LLC
• Countryside Counseling Center, LLC
• Tyler James Cox, MSW
• Stewart L. Crow, D.D.S. P.A.

• Family Nurse Practitioner in Independence, KS
• Providers in Independence, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.