Eboni Nicole Cornish, M.D.

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Practice address

1860 Town Center Drive
260
Reston, VA 20190-1928

Phone

(703) 709-1119

NPI assigned

Jan 24, 2009

Sex

Female

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 11, 2018 through Jan 11, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Amen Clinics, Inc DC

  • Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
  • Reston, VA
  • NPI 1124534607
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1232755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1891933131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3391 VINELAND PLACE",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220261860",
            "telephone_number": "401-559-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DRIVE",
            "address_2": "260",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201901928",
            "telephone_number": "703-709-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNISH",
        "first_name": "EBONI",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-24",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Copeland, LPC, M ED.
• Jennifer Corbet
• Anju Bhargava Corbishdale, PH.D.
• Eleanor Corcoran, RNFA
• Lauren Cormier
• Cornita Mental Health Services, LLC
• Bruce V Corsino, PSY. D.
• Stephanie U Cortez, MSN, FNP-C
• Jessica Mary Cortezzo, CRNA
• Shane Ryan Costa, D.D.S

• General Acute Care Hospital in Reston, VA
• Providers in Reston, VA by specialty
• General Acute Care Hospital in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.