Christopher Ja Cornell, DO, MS, ATC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

DOS-2325-0 Issued in HI

Practice address

47-567 Alawiki St
Kaneohe, HI 96744-4684

Phone

(727) 384-1414

NPI assigned

Mar 26, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  HI

  Medicare reassignment NPD

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1831776699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47-567 ALAWIKI ST",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444684",
            "telephone_number": "808-393-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47-567 ALAWIKI ST",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444684",
            "telephone_number": "727-384-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "JA",
        "name_prefix": "Dr.",
        "credential": "DO, MS, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "7812",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "HI",
            "license": "DOS-2325-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Michael Coleon
• Community Mental Health Center Clubhouse-Ko'Olau
• Alexander R. Concepcion, D.C.
• Kelly Kuipo Contrades, LMT
• Brooke Arlene Conway, LCSW
• Shane Lyka Corpuz
• Ashlyn L Crawford, LMT
• Karen Elizabeth Crisler, MA, BCBA
• Kerri L.K. Cummins, RN
• Fiona Custer

• General Practice Physician in Kaneohe, HI
• Providers in Kaneohe, HI by specialty
• General Practice Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.