Individual provider Active NPI

Jennifer Lynne Joy Cornejo

  • Audiologist
  • Las Vegas, NV
National Provider Identifier
1992972293
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-196 Issued in NV
Practice address
5320 S Rainbow Blvd Ste 250
Las Vegas, NV 89118-1896
Phone
(702) 671-6480
Fax
(702) 671-6481
NPI assigned
May 15, 2008
Last updated
Nov 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A-196 NV Primary

Addresses

Primary practice location

5320 S Rainbow Blvd Ste 250
Las Vegas, NV 89118-1896

Mailing address

3016 W Charleston Blvd Ste 100
Las Vegas, NV 89102-1973
Phone (818) 451-9016

Other practice location 1

3150 N Tenaya Way
#112
Las Vegas, NV 89128-0443
Phone (702) 562-1777

Other practice location 2

5380 S Rainbow Blvd Ste 324
Las Vegas, NV 89118
Phone (702) 992-6828

Other identifiers 1

IdentifierTypeStateIssuer
1992972293MedicaidNV

Other names 1

  • Jennifer Lynne Joy Cornejo Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080604000146 NV Practitioner - Qualified Audiologist 7214007186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

5320 S Rainbow Blvd
Suite 250
Las Vegas, NV 89118-1807
Phone (702) 671-6480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Jul 1, 2017 Accepting new patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Jul 1, 2017 Accepting new patients
Unsom Multi-Spec GRP Pract S Past Accepting new patients

Locations

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

1707 W Charleston Blvd
Ste 220
Las Vegas, NV 89102
Phone (702) 671-5070

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

3150 N Tenaya Way
Ste 112
Las Vegas, NV 89128
Phone (702) 562-1777

5320 S Rainbow Blvd
Ste 250
Las Vegas, NV 89118
Phone (702) 671-6480

6375 W Charleston Blvd
Ste A100A
Las Vegas, NV 89146
Phone (702) 253-0818

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1992972293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "818-451-9016",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD STE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181896",
            "telephone_number": "702-671-6480",
            "fax_number": "702-671-6481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3150 N Tenaya Way",
            "address_2": "#112",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280443",
            "country_code": "US",
            "telephone_number": "702-562-1777",
            "fax_number": "702-671-6481",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5380 S Rainbow Blvd Ste 324",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89118",
            "country_code": "US",
            "telephone_number": "702-992-6828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOY CORNEJO",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NV",
            "license": "A-196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992972293",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JOY CORNEJO",
            "middle_name": "LYNNE",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.