John Watt Cornelius, M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

G11954 Issued in MD

Practice address

12900 Middlebrook Road
Germantown, MD 20874

Phone

(301) 588-8881

NPI assigned

Jan 29, 2007

Last updated

Jul 9, 2007By 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 2

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 2, 2019 through Nov 2, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982740601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 EDMUNDS PLACE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20016",
            "telephone_number": "202-244-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 MIDDLEBROOK ROAD",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "20874",
            "telephone_number": "301-588-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "JOHN",
        "middle_name": "WATT",
        "name_prefix": "Mr.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "G11954",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LG50028254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nancy E. Copeland, M.D.
• Amanda Cornaglia, LGPC
• Cornerstone Montgomery, Inc.
• Shabreea Lee Cornick-Normil, M.S., CCC-SLP
• Sarah Costlow, MS, CCC- SLP
• Couples and Relationship Counseling Center, LLC
• Suzanne M Cowan, PT

• Clinical Social Worker in Germantown, MD
• Providers in Germantown, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.