Individual provider Active NPI

Renee Christine Cornelison, RPH

  • Pharmacist
  • Millbrook, AL
National Provider Identifier
1720425739
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13264 Issued in AL
Practice address
5290 Sycamore Dr
Millbrook, AL 36054-2004
Phone
(334) 207-2861
NPI assigned
May 30, 2013
Last updated
May 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13264 AL Primary

Addresses

Primary practice location

5290 Sycamore Dr
Millbrook, AL 36054-2004

Mailing address

5290 Sycamore Dr
Millbrook, AL 36054-2004
Phone (334) 207-2861

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13264ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1720425739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5290 SYCAMORE DR",
            "city": "MILLBROOK",
            "state": "AL",
            "postal_code": "360542004",
            "telephone_number": "334-207-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5290 SYCAMORE DR",
            "city": "MILLBROOK",
            "state": "AL",
            "postal_code": "360542004",
            "telephone_number": "334-207-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELISON",
        "first_name": "RENEE",
        "middle_name": "CHRISTINE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "13264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millbrook, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.