Kendra A. Cornwall, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO2248 Issued in ME

Practice address

25 Middle St
Portland, ME 04101-4869

Phone

(207) 415-0380

NPI assigned

Jun 23, 2008

Last updated

Aug 23, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Maine Behavioral Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Biddeford, ME
  • NPI 1891733309
  NPD (past)

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1700047792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MIDDLE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014869",
            "telephone_number": "207-415-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MIDDLE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014869",
            "telephone_number": "207-415-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWALL",
        "first_name": "KENDRA",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "DO2248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn Cormier
• Diane H. Cormier, F.N.P.
• Joshua Eric Cormier, PA
• Cornerbrook Plaza Eye Care P a (Portland Eyecare)
• Cornerstone Chiropractic & Rehabilitation, PA
• Mary-Lynn Corradi, LCPC
• Elisabeth R Corrales, LCSW
• Mary E Corrigan, PNP
• Laren Corrin
• Hope Elizabeth Corrow, PHARMD

• Psychiatry Physician in Portland, ME
• Providers in Portland, ME by specialty
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; 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.