Individual provider Active NPI

Torland E Cornelius-Adkins, LCSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1639169949
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2783-123 Issued in WI
Practice address
2640 W Point Rd
Green Bay, WI 54304-1344
Phone
(920) 869-2711
NPI assigned
Oct 27, 2005
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2783-123 WI Primary

Addresses

Primary practice location

2640 W Point Rd
Green Bay, WI 54304-1344

Mailing address

PO Box 365
Oneida, WI 54155-0365
Phone (920) 869-2711

Other identifiers 1

IdentifierTypeStateIssuer
39661500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110216000584 WI Practitioner - Clinical Social Worker 9335320837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oneida NationGroup PAC ID 6800794074, 36 clinicians

Practice addresses (Care Compare)

2640 W Point Rd
Green Bay, WI 54304-1344
Phone (920) 490-3701

Merit-based Incentive Payment System (MIPS)

Final score
93.87 of 100Reported as group
Quality
76.81
Promoting interoperability
100
Improvement activities
40
Cost
86.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2783-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oneida Nation CurrentSince Jan 1, 2003 Accepting new patients
Oneida Nation Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1639169949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "ONEIDA",
            "state": "WI",
            "postal_code": "541550365",
            "telephone_number": "920-869-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 W POINT RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041344",
            "telephone_number": "920-869-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS-ADKINS",
        "first_name": "TORLAND",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2783-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39661500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.