Carol S. Cornelius, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

931 Issued in NE

Practice address

900 Lincoln Ave
Grant, NE 69140-3095

Phone

(308) 352-7200

Fax

(308) 352-7290

NPI assigned

Dec 4, 2006

Last updated

Oct 2, 2019By 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 1

Addresses

Other names 1

• Ms. Carol S. Russell Former name

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Perkins County Hospital DistrictGroup PAC ID 0840109823, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Perkins County Health Services Hospital, Grant, NE, CCN 281356

Merit-based Incentive Payment System (MIPS)

Final score

31.28 of 100Reported as group

Quality

19.15

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Perkins County Hospital District

  dba Perkins County Health Services

  • Critical Access Hospital
  • Grant, NE
  • NPI 1629086012
  Medicare reassignment Care Compare group NPD
• Perkins County Hospital District

  dba Perkins County Community Hospital

  • Critical Access Hospital
  • Grant, NE
  • NPI 1437167970
  Medicare reassignment
• Perkins County Hospital District

  dba Perkins County Family Clinic

  • Critical Access Hospital Clinic/Center
  • Ogallala, NE
  • NPI 1720639974
  NPD
• Perkins County Hospital District

  dba Grant Medical Clinic

  • Critical Access Hospital Clinic/Center
  • Grant, NE
  • NPI 1720095755
  NPD (past)

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

• Perkins County Hospital District

  dba Perkins County Health Services

  • Critical Access Hospital
  • Grant, NE
  • NPI 1629086012
  Care Compare affiliation

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1598823528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 CENTRAL AVE",
            "city": "GRANT",
            "state": "NE",
            "postal_code": "691403099",
            "telephone_number": "308-352-7100",
            "fax_number": "308-352-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LINCOLN AVE",
            "city": "GRANT",
            "state": "NE",
            "postal_code": "691403095",
            "telephone_number": "308-352-7200",
            "fax_number": "308-352-7290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "912 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Grant",
            "state": "NE",
            "postal_code": "691403099",
            "country_code": "US",
            "telephone_number": "308-352-7100",
            "fax_number": "308-352-7290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "CAROL",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "RUSSELL",
            "middle_name": "S.",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Banner Health Physicians Colorado LLC
• Banner Health Physicians West LLC
• John Matthew Byrd, M.D.
• Colglazier Clinic
• Clifford Ray Colglazier, MD
• County of Perkins
• Ruth Demmel, MD
• Traci E Draucker, PA-C
• First Insight Eyecare, LLC
• Shannon Fisher, PA-C

• Physician Assistant in Grant, NE
• Providers in Grant, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.