Individual provider Active NPI

Brian William Cornell, DPM

  • Podiatrist
  • Newport, RI
National Provider Identifier
1881773018
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DPM00195 Issued in RI
Practice address
55 Memorial Boulevard
Newport, RI 02840-3679
Phone
(401) 846-2800
Fax
(401) 849-4899
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DPM00195 RI Primary

Addresses

Primary practice location

55 Memorial Boulevard
Newport, RI 02840-3679

Mailing address

55 Memorial Boulevard
Newport, RI 02840-3679
Phone (401) 846-2800

Other identifiers 3

IdentifierTypeStateIssuer
9007121MedicaidRI
2700178OtherRIUNITED HEALTHCARE
71215OtherRIBLUE CROSS BLUE SHIELD

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DPM00195RIMDPodiatrist
00195RIMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Foot Care, Inc Podiatrist PastSince Sep 10, 2012 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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881773018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MEMORIAL BOULEVARD",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028403679",
            "telephone_number": "401-846-2800",
            "fax_number": "401-849-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MEMORIAL BOULEVARD",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028403679",
            "telephone_number": "401-846-2800",
            "fax_number": "401-849-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "BRIAN",
        "middle_name": "WILLIAM",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "DPM00195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9007121",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2700178",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "71215",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.