Individual provider Active NPI

Jennifer Merlaine Cornie

  • Counselor
  • Twin Falls, ID
National Provider Identifier
1609628254
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
479 Polk St # 3B
Twin Falls, ID 83301-4850
Phone
(208) 404-3636
NPI assigned
Apr 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

479 Polk St # 3B
Twin Falls, ID 83301-4850

Mailing address

479 Polk St # 3B
Twin Falls, ID 83301-4850
Phone (208) 404-3636

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clearcheck Recovery LLC CurrentSince Apr 9, 2024 Accepting new patients
Clearcheck Holdings LLC Current Accepting new patients

Locations

479 Polk St
#3B
Twin Falls, ID 83301
Phone (208) 404-3636

598 Addison Ave W
Twin Falls, ID 83301
Phone (208) 404-3636

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1609628254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 POLK ST # 3B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014850",
            "telephone_number": "208-404-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 POLK ST # 3B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014850",
            "telephone_number": "208-404-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNIE",
        "first_name": "JENNIFER",
        "middle_name": "MERLAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.