Carissa R Cornell, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R34040 Issued in ND

Practice address

1221 W Divide Ave Ste 202
Bismarck, ND 58501-1224

Phone

(877) 522-1275

Fax

(833) 888-7145

NPI assigned

Jul 17, 2012

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

Medicare fee-for-service enrollment

Enrolled in ND, WA, MT, OR, NM, DC, MD, AR8 enrollments

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 8

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ideal Telemedicine Services LLC 47 clinicians

Ideal Option PLLC 90 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Ideal Option, PLLC

  • Clinic/Center
  • Kennewick, WA
  • NPI 1457788275

  AR, MD, MT, ND, NM, OR, WA

  Medicare reassignment Care Compare group
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Renton, WA
  • NPI 1346754868

  AR, DC, MD, MT, ND, NM, OR, WA

  Medicare reassignment Care Compare group
• Sanford Bismarck

  • Multi-Specialty Clinic/Center
  • Bismarck, ND
  • NPI 1811941172

  ND

  Medicare reassignment NPD
• Ideal Option, PLLC

  • Clinical Medical Laboratory
  • Kennewick, WA
  • NPI 1841648623
  Care Compare group NPD
• Ideal Option, PLLC

  • Clinical Medical Laboratory
  • Renton, WA
  • NPI 1538662663
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Ideal Option, PLLC

  • Clinic/Center
  • Newport, OR
  • NPI 1366320327
  NPD (past)
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Rosedale, MD
  • NPI 1427561828
  NPD (past)

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1629323605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SW 7TH ST STE A205",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572983",
            "telephone_number": "509-222-1275",
            "fax_number": "509-491-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W DIVIDE AVE STE 202",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011224",
            "telephone_number": "877-522-1275",
            "fax_number": "833-888-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "CARISSA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R34040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafael Eugenio Coplin Reynoso, MD
• David Coppock
• Kayla Corbin, PHARMD
• Core Family Chiropractic, PLC
• William Eugene Cornatzer Jr., M.D.
• Jennie L Cornell
• Corner Post Counseling, PLLC
• Cornerstone Caregiving East LLC
• Caitlin Cortes
• Stephanie D Cortes, CNA

• All providers in Bismarck, ND
• Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.