KELVINA NICOLE CORNETT (NPI# 1174122782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174122782 |
| Entity Type | Individual |
| Full Name | KELVINA NICOLE CORNETT |
| Practice Address |
13317 Se Powell Blvd Portland OR 97236-3335 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5032380769 |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2020-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| Street Address |
13317 SE POWELL BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97236-3335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396857538 | Mark Scott Soine | Counselor | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2006-08-31 |
| 1841897105 | David Brian Prescott | Technician | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-10-08 |
| 1811501505 | Genalyn Inovejas Moore | Case Manager/Care Coordinator | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-09-01 |
| 1245844935 | Jacquelyn Boliba Soule | Technician | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-09-01 |
| 1407468085 | Elijah James Boone | Counselor | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-08-17 |
| 1386261055 | Maura Jean Ores Phillips | Technician | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-06-29 |
| 1649896051 | Cynthia E Ochoa Cavillo | Case Manager/Care Coordinator | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-06-22 |
| 1457976599 | Nicole Dawn Schmidlin | Case Manager/Care Coordinator | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-06-15 |
| 1790308302 | Alexander L Syum | Case Manager/Care Coordinator | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-05-19 |
| 1306468160 | Tabatha B Kringelhede | Case Manager/Care Coordinator | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-05-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
| 1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
| 1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
| 1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
| 1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
| 1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
| 1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
| 1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
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| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862994 | Tanika Barsegian | Technician | 15311 Se River Forest Dr, Portland, OR 97267-3501 | 2020-02-11 |
| 1740831627 | Edith Joan Marti | Technician | 304 Se 162nd Ave Apt 405, Portland, OR 97233-3866 | 2019-09-23 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1265975932 | Ocean Home Healthcare LLC | Technician | 68 Bishop St Ste 2, Portland, ME 04103-2681 | 2016-11-29 |
| 1235367228 | New England Family Healthcare | Technician | 125 Presumpscot St., #9, Portland, ME 04103 | 2009-06-29 |
| 1841899275 | Bridgett J Palmer | Technician | 13942 Ne Glisan St, Portland, OR 97230-3350 | 2020-10-16 |
| 1083212781 | Haili Michelle Jones | Technician | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2020-10-14 |
| 1316545056 | Cash A Crouse | Technician | 2330 Ne Siskiyou St, Portland, OR 97212-2471 | 2020-10-14 |
| 1275131922 | Elizabeth Rose Anderson | Technician | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-10-14 |
| 1841897105 | David Brian Prescott | Technician | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2020-10-08 |
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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.