Kevin Cornwell, O.D.
Individual provider Active NPI Optometrist · San Andreas, CA
NPI 1881060366 · NPPES record last updated Oct 13, 2021
Key facts
- NPI
- 1881060366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 33361 (CA)
- Practice address
- 1113A Hwy 49
San Andreas, CA 95249-9524 - Phone
- (209) 755-1480
- NPI assigned
- Aug 19, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- New England College of Optometry, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Health Care Partners of South Carolina, Inc.
Practice addresses (Care Compare)
1606 B Main St
Conway, SC 29526-3572
Phone (843) 248-4700
1608 Main St
Conway, SC 29526-3572
Phone (843) 248-4700
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230320001724 | SC | Practitioner - Optometry | 3971889825 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2320 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Care Partners of South Carolina, Inc. | Current |
Accepting new patients | |
| Health Care Partners of South Carolina, Inc. | Current | Accepting new patients | |
| Health Care Partners of South Carolina, Inc. | Current |
Accepting new patients | |
| Health Care Partners of South Carolina, Inc. | Past | Accepting new patients | |
| Health Care Partners of South Carolina, Inc. | Past | Accepting new patients |
Locations
1606B Main St
Conway, SC 29526
1708 Oak St
Conway, SC 29526
Phone (843) 488-6363
1608 Main St
Conway, SC 29526
Phone (843) 488-6032
145 Palmetto Pointe Rd
Marion, SC 29571
Phone (843) 423-2400
Interoperability endpoints
- kevin.cornwell@hcposc.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 33361 | CA | Yes |
Addresses
Primary practice location
1113A Hwy 49
San Andreas, CA 95249-9524
Mailing address
850 Stella Dr
Murphys, CA 95247-9483
Phone (321) 446-1902
Other practice location 1
5192 Hospital Road
Mariposa, CA 95338
Phone (209) 966-0780
Other providers in San Andreas, CA
- Community Medical Centers
- Community Medical Team Acute Care Corporation
- Michael Compton
- Kulauri Cooper
- Samantha Jolene Cooper
- Whitney Lucille Couchman
- County of Calaveras
- County of Calaveras
- County of Calaveras
- County of Calaveras
All providers in San Andreas, CA · Optometrist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.