Individual provider Active NPI

Heather Anne Cornell, BCBA

  • Behavior Analyst
  • Colorado Springs, CO
National Provider Identifier
1770090771
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-59888 Issued in CO
Practice address
2760 Fieldstone Rd
Colorado Springs, CO 80919
Phone
(719) 203-6903
NPI assigned
Dec 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-22-59888 CO Primary
Behavior Technician 106S00000X RBT-17-40949 CO

Addresses

Primary practice location

2760 Fieldstone Rd
Colorado Springs, CO 80919

Mailing address

2760 Fieldstone Rd
Colorado Springs, CO 80919-3100

Other identifiers 1

IdentifierTypeStateIssuer
RBT-17-40949OtherBACB

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

State licenses

LicenseStateTypeSpecialty
RBT-17-40949COMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1770090771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 FIELDSTONE RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 FIELDSTONE RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80919",
            "telephone_number": "719-203-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "HEATHER",
        "middle_name": "ANNE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-29",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-22-59888",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": "RBT-17-40949",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "RBT-17-40949",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.