Individual provider Active NPI

Laine Montgomery Cornelison, MD

  • Family Medicine Physician
  • Frederick, MD
National Provider Identifier
1972762995
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D72798 Issued in MD
Practice address
7190 Crestwood Blvd
Kaiser Permanente Frederick Medical Center
Frederick, MD 21703-7314
Phone
(240) 529-1700
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD040239 DC
Family Medicine Physician 207Q00000X D72798 MD Primary
Family Medicine Physician 207Q00000X 0101249806 VA

Addresses

Primary practice location

7190 Crestwood Blvd
Kaiser Permanente Frederick Medical Center
Frederick, MD 21703-7314

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Other names 1

  • Dr. Laine Ann Cornelison Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110907001385 MD Practitioner - Family Practice 1052581733 Reassigns benefits to 1 organization
I20130826000106 DC Practitioner - Family Practice 1052581733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
George Washington University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301
Phone (240) 632-4000

7190 Crestwood Blvd
Frederick, MD 21703-7314
Phone (240) 529-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD040239DCMDFamily Medicine Physician
D72798MDMDFamily Medicine Physician
0101249806VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 15, 2011 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 15, 2011 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine CurrentSince Jun 2, 2013 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660

2101 E Jefferson St
Ste 6
Rockville, MD 20852

2101 E Jefferson St
#4E
Rockville, MD 20852

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Organizations & group practices 5

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1972762995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7190 CRESTWOOD BLVD",
            "address_2": "KAISER PERMANENTE FREDERICK MEDICAL CENTER",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037314",
            "telephone_number": "240-529-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY CORNELISON",
        "first_name": "LAINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD040239",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D72798",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101249806",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7190 Crestwood Blvd",
            "address_2": "Kaiser Permanente Frederick Medical Center",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217037314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAINE",
            "last_name": "CORNELISON",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.