Individual provider Active NPI

Tania Yessica Valencia Cornejo

  • Family Nurse Practitioner
  • Austin, IN
National Provider Identifier
1780488205
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71016503A Issued in IN
Practice address
25 W Main St
Austin, IN 47102-1303
Phone
(812) 794-8100
Fax
(812) 794-8200
NPI assigned
Apr 3, 2025
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71016503A IN Primary

Addresses

Primary practice location

25 W Main St
Austin, IN 47102-1303

Mailing address

2200 W Main St
Richmond, IN 47374-3882
Phone (765) 973-9294

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250702003903 IN Practitioner - Nurse Practitioner 2668985540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Well Care Community Health IncGroup PAC ID 9335576131, 13 clinicians

Practice addresses (Care Compare)

25 W Main St
Foundations Family Medicine
Austin, IN 47102-1303
Phone (812) 794-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71016503AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Well Care Community Health, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Well Care Community Health, Inc. CurrentSince Jun 1, 2025 Accepting new patients

Locations

25 W Main St
Austin, IN 47102
Phone (812) 252-9020

203 E Main St
Richmond, IN 47374
Phone (765) 973-9294

2200 W Main St
Richmond, IN 47374
Phone (765) 973-9294

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1780488205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W MAIN ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473743882",
            "telephone_number": "765-973-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W MAIN ST",
            "city": "AUSTIN",
            "state": "IN",
            "postal_code": "471021303",
            "telephone_number": "812-794-8100",
            "fax_number": "812-794-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA CORNEJO",
        "first_name": "TANIA",
        "middle_name": "YESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-03",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71016503A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, IN

Sources for this page

Verify at the official NPI Registry.