Active NPI
Wesley Cornelius
- Community Health Worker
- Eureka, CA
National Provider Identifier
1871040261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 720 Wood St
Eureka, CA 95501-4413 - Phone
- (707) 445-7710
- NPI assigned
- Sep 2, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Recreational Therapist Assistant | 226000000X | |||
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
720 Wood St
Eureka, CA 95501-4413
Mailing address
1070 W Causeway Approach Ste B
Mandeville, LA 70471-3188
Phone (985) 590-0859
Other practice location 1
19331 N 12th St
Covington, LA 70433-5228
Phone (985) 400-5901
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walk With Me Community Improvement Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Covington, LA
- NPI 1457783078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703030400000",
"number": "1871040261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1070 W CAUSEWAY APPROACH STE B",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704713188",
"telephone_number": "985-590-0859",
"fax_number": "985-400-5164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 WOOD ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955014413",
"telephone_number": "707-445-7710"
}
],
"practiceLocations": [
{
"address_1": "19331 N 12th St",
"address_purpose": "LOCATION",
"city": "Covington",
"state": "LA",
"postal_code": "704335228",
"country_code": "US",
"telephone_number": "985-400-5901",
"fax_number": "985-400-5164",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CORNELIUS",
"first_name": "WESLEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-02",
"last_updated": "2023-12-20",
"certification_date": "2023-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "226000000X",
"taxonomy_group": "",
"desc": "Recreational Therapist Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.