Craig Marvin Cornick, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0234 Issued in IA

Practice address

411 West Agency Suite 1
Universal Therapy Group
West Burlington, IA 52655-1702

Phone

(319) 752-7899

NPI assigned

Dec 5, 2011

Last updated

Dec 5, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Universal Therapy Group

  • Physical Therapy Assistant
  • West Burlington, IA
  • NPI 1124394085
  NPD (past)
• Universal Therapy Group LLC

  • Occupational Therapist
  • Burlington, IA
  • NPI 1902190259
  NPD (past)

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1881962959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WEST AGENCY, SUITE 1",
            "address_2": "UNIVERSAL THERAPY GROUP",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551702",
            "telephone_number": "319-752-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WEST AGENCY SUITE 1",
            "address_2": "UNIVERSAL THERAPY GROUP",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551702",
            "telephone_number": "319-752-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNICK",
        "first_name": "CRAIG",
        "middle_name": "MARVIN",
        "name_prefix": "Mr.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "0234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marissa Ann Crowdis, D.O
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• Tarah Cullen, OTR/L

• Speech-Language Pathologist in West Burlington, IA
• Providers in West Burlington, IA by specialty
• Speech-Language Pathologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.