Active NPI
Rebecca Cornwell, MED, BCBA
- Behavior Analyst
- Montgomery, AL
National Provider Identifier
1689116162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2017-090
- Practice address
- 101 Coliseum Blvd
Montgomery, AL 36109-2707 - Phone
- (334) 277-4372
- NPI assigned
- Nov 15, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2017-090 | AL | Primary |
Addresses
Primary practice location
101 Coliseum Blvd
Montgomery, AL 36109-2707
Mailing address
101 Coliseum Blvd
Montgomery, AL 36109-2707
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2017-090 | Other | AL | ALABAMA BEHAVIOR ANALYST LICENSURE BOARD |
| 13999037 | Other | CAQH | |
| 1-14-15309 | Other | BEHAVIOR ANALYST CERTIFICATION BOARD |
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017-090 | AL | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1689116162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 COLISEUM BLVD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361092707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 COLISEUM BLVD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361092707",
"telephone_number": "334-277-4372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNWELL",
"first_name": "REBECCA",
"credential": "MED, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-15",
"last_updated": "2020-09-16",
"certification_date": "2020-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AL",
"license": "2017-090",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALABAMA BEHAVIOR ANALYST LICENSURE BOARD",
"identifier": "2017-090",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "13999037",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
"identifier": "1-14-15309",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.