Kevin Cornwell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

33361 Issued in CA

Practice address

1113A Hwy 49
San Andreas, CA 95249-9524

Phone

(209) 755-1480

NPI assigned

Aug 19, 2015

Last updated

Oct 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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.Group PAC ID 3577668763, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.cornwell@hcposc.eclinicaldirectplus.com

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.

• Health Care Partners of South Carolina, Inc.

  • Federally Qualified Health Center (FQHC)
  • Conway, SC
  • NPI 1043395346
  Medicare reassignment Care Compare group NPD
• Health Care Partners of South Carolina, Inc.

  • Federally Qualified Health Center (FQHC)
  • Conway, SC
  • NPI 1063079549
  NPD
• Health Care Partners of South Carolina, Inc.

  • Federally Qualified Health Center (FQHC)
  • Marion, SC
  • NPI 1861874430
  NPD
• Health Care Partners of South Carolina, Inc.

  • Federally Qualified Health Center (FQHC)
  • Johnsonville, SC
  • NPI 1639255631
  NPD (past)
• Health Care Partners of South Carolina, Inc.

  • Federally Qualified Health Center (FQHC)
  • Marion, SC
  • NPI 1770668824
  NPD (past)

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1881060366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 STELLA DR",
            "city": "MURPHYS",
            "state": "CA",
            "postal_code": "952479483",
            "telephone_number": "321-446-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113A HWY 49",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499524",
            "telephone_number": "209-755-1480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5192 Hospital Road",
            "address_purpose": "LOCATION",
            "city": "Mariposa",
            "state": "CA",
            "postal_code": "95338",
            "country_code": "US",
            "telephone_number": "209-966-0780",
            "fax_number": "209-398-8758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "KEVIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-19",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michael Compton, CATCII
• Kulauri Cooper
• Whitney Lucille Couchman, OTR/L
• County of Calaveras
• County of Calaveras (Calaveras County Behavioral Health Services)
• County of Calaveras (Calaveras Public Health Services)
• County of Calaveras (County of Calaveras Detention Facility)

• Optometrist in San Andreas, CA
• Providers in San Andreas, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.