Individual provider Active NPI

William B Cornelius, O.D.

  • Optometrist
  • Altamonte Springs, FL
National Provider Identifier
1598755308
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC00976 Issued in FL
Practice address
160 Boston Ave
Altamonte Springs, FL 32701-4798
Phone
(407) 834-7776
Fax
(407) 834-0973
NPI assigned
Oct 24, 2005
Last updated
Feb 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC00976 FL Primary

Addresses

Primary practice location

160 Boston Ave
Altamonte Springs, FL 32701-4798

Mailing address

160 Boston Ave
Altamonte Springs, FL 32701-4798
Phone (407) 834-7776

Other identifiers 1

IdentifierTypeStateIssuer
084154400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC00976FLMDOptometrist
976FLMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1598755308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BOSTON AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014798",
            "telephone_number": "407-834-7776",
            "fax_number": "407-834-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BOSTON AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014798",
            "telephone_number": "407-834-7776",
            "fax_number": "407-834-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC00976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084154400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.