SHELLIE CORNELIUS (NPI# 1134107352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134107352 |
| Entity Type | Individual |
| Full Name | SHELLIE CORNELIUS |
| Credential | PA |
| Practice Address |
1541 Medical Dr Tallahassee FL 32308-4615 |
| Practice Telephone | 8504317805 |
| Practice Fax Number | 8504317809 |
| Mailing Telephone | 8504317805 |
| Mailing Fax Number | 8504317809 |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2019-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA9106607 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | 0110840579 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1541 MEDICAL DR |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32308-4615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902391386 | Michelle Noel Kostic | Nurse Practitioner | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2018-06-27 |
| 1497291207 | Kyrie Stewart | Nurse Practitioner | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2017-01-18 |
| 1326411125 | Kelly A Bane | Physician Assistant | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2015-11-03 |
| 1629467352 | Gary Johnston Jr. | Nurse Practitioner | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2015-01-19 |
| 1982013330 | Pooja Patel | Physician Assistant | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2014-08-11 |
| 1750799151 | Charlene Small | Nurse Practitioner | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2014-07-29 |
| 1467894279 | Ashley C Duke | Nurse Practitioner | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2013-07-22 |
| 1073860383 | Theresa Bandorf Winton | Nurse Practitioner | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2012-08-07 |
| 1750640751 | Yvon Petiote | Family Medicine | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2012-05-10 |
| 1972893303 | Janine L Williams | Nurse Practitioner | 1541 Medical Dr, Tallahassee, FL 32308-4615 | 2011-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
| 1972165108 | Covenant Home Health Care, LLC | Home Health | 1921 Capital Circle Ne, Tallahassee, FL 32308 | 2019-07-09 |
| 1548735798 | North Florida Rehab Solutions | Hospitalist | 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 | 2018-10-03 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1487133625 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 | 2018-08-08 |
| 1629566724 | Total Health & Wellness Home Care, LLC | Home Health | 1325 Mahan Dr., Tallahassee, FL 32308 | 2018-04-25 |
| 1669979480 | Beth North, Lcsw, LLC | Social Worker | 1325 Mahan Drive, Tallahassee, FL 32308 | 2018-04-09 |
| 1750885919 | Robert E Ashmore Jr Md | Obstetrics & Gynecology | 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 | 2018-03-22 |
| 1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
| 1235657834 | Traci R Raybon | Occupational Therapist | 1924 Hidden Valley, Tallahassee, FL 32308 | 2017-09-03 |
| Find all providers in zip 32308 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104481886 | Jackson Ray Handley Jr. | Physician Assistant | 650 Old Dirt Rd, Tallahassee, FL 32317-8575 | 2019-05-07 |
| 1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
| 1417360074 | Kartik Gopal | Physician Assistant | 1401 Centerville Rd Unit 710, Tallahassee, FL 32308-4641 | 2014-06-11 |
| 1538496955 | Dawn K Jones | Physician Assistant | 2040 Fleischmann Road, Tallahassee, FL 32308 | 2009-11-05 |
| 1306179734 | Rebekah G Simmons-todd | Physician Assistant | 2420 E Plaza Dr, Tallahassee, FL 32308-5353 | 2009-09-17 |
| 1851624985 | Beverly Carol Walker | Physician Assistant | 1632 Riggins Road, Tallahassee, FL 32308-5316 | 2009-09-08 |
| 1346467578 | Carrie Lynn Snider | Physician Assistant | 1707 Riggins Road, Tallahassee, FL 32308-5317 | 2007-04-19 |
| 1992777973 | Julia M Mitchell | Physician Assistant | 2452 Mahan Dr Ste 101, Tallahassee, FL 32308-5377 | 2006-02-03 |
| 1841261336 | Gregory Sydnor Laffitte | Physician Assistant | 1300 Miccosukee Rd, Hospitalists Group, Tallahassee, FL 32308-5054 | 2006-02-01 |
| 1407474836 | Erica Calil | Physician Assistant | 1707 Riggins Rd, Tallahassee, FL 32308-5317 | 2020-07-13 |
| Find all providers in TALLAHASSEE | ||||
| City | TALLAHASSEE |
| Zip Code | 32308 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.