NPIMap

Organization Active NPI

Cornerstone Health Services LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Tavares, FL
National Provider Identifier
1912327941
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
CORNERSTONE HEALTH SERVICES LLC
Practice address
2445 Lane Park Rd
Tavares, FL 32778-9648
Phone
(352) 343-1341
Fax
(352) 343-0325
NPI assigned
Apr 17, 2014
Last updated
May 7, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CORNERSTONE HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Authorized official

Name
Mr. Charles O Lee
Title
President/Ceo
Phone
(352) 343-1341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X Primary

Addresses

Primary practice location

2445 Lane Park Rd
Tavares, FL 32778-9648

Mailing address

2445 Lane Park Rd
Tavares, FL 32778-9648
Phone (352) 343-1341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140916000252 FL Part B Supplier - Clinic/Group Practice 2668691148 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
Practice locations: Orlando, FL; Winter Haven, FL; Tavares, FL; Lakeland, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cornerstone Centers for Wellbeing2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1912327941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 LANE PARK RD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327789648",
            "telephone_number": "352-343-1341",
            "fax_number": "352-343-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 LANE PARK RD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327789648",
            "telephone_number": "352-343-1341",
            "fax_number": "352-343-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE HEALTH SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORNERSTONE HEALTH SERVICES, INC.",
        "enumeration_date": "2014-04-17",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "352-343-1341",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.