JESSICA ELIZABETH CORNETT (NPI# 1245839083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245839083 |
| Entity Type | Individual |
| Full Name | JESSICA ELIZABETH CORNETT |
| Credential | CTRS |
| Practice Address |
508 Fulton St Durham NC 27705-3875 |
| Practice Telephone | 9192860411 |
| Mailing Telephone | 9192860411 |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225800000X | Recreation Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942768833 | Jessica Cornett | Nurse Practitioner | 800 S Ash St, Nevada, MO 64772-3224 | 2019-03-09 |
| Street Address |
508 FULTON ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-3875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043217086 | Stuart Hall Manning | Internal Medicine | 508 Fulton St, C/o Durham Va Medical Center, Durham, NC 27705-3875 | 2005-07-06 |
| 1043819808 | Rebecca Parker Maccioli | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
| 1174122055 | Aline Xayasouk | Occupational Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-21 |
| 1730786187 | Kathryn Masincupp | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-07 |
| 1700490349 | Sarah Elizabeth Parker | Nurse Practitioner | 508 Fulton St, Durham, NC 27705-3875 | 2020-09-01 |
| 1144833716 | Phillip Charles Tampis | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-24 |
| 1164033445 | Alexandra Demascole | Social Worker | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-11 |
| 1386254498 | Krishna Rana | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
| 1730799842 | Jinah Han | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
| 1396354700 | Cutisha Moore-hicks | Occupational Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
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| Taxonomy Code | 225800000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Recreation Therapist |
| A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |
| Notes: Source: Joel A. DeLisa and Bruce M. Gans, Rehabilitation Medicine: Principles and Practice Second Edition, J.B. Lippincott Company, Philadelphia: 1993, p. 7 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374314 | Tiffany Sheree Smith | Recreation Therapist | 508 Fulton St # 117c, Durham, NC 27705-3875 | 2020-10-23 |
| 1528667243 | Rashonna Avery | Recreation Therapist | 508 Fulton St # 117c, Durham, NC 27705-3875 | 2020-10-23 |
| 1992304745 | Kendra Darcel Monden | Recreation Therapist | 508 Fulton St # 117c, Durham, NC 27705-3875 | 2020-10-22 |
| 1326647181 | Abena Kai Jones-boone | Recreation Therapist | 508 Fulton St # 117c, Durham, NC 27705-3875 | 2020-10-22 |
| 1043819808 | Rebecca Parker Maccioli | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
| 1629511910 | Bryan Mcfarland | Recreation Therapist | 459 Wallingford Rd, Durham, CT 06422-1125 | 2016-11-18 |
| 1740650977 | Northeast Passage Program of The University of New Hampshire | Recreation Therapist | 4 Library Way, G-1 Hewitt Hall, Durham, NH 03824-3520 | 2015-09-30 |
| 1467499517 | Jean L Wipperman | Recreation Therapist | 508 Fulton St, Pm&rs 117, Durham, NC 27705-3875 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194356170 | Shaverence Lawanda Outlaw | Recreation Therapist | 3890 Old Vineyard Rd Apt 86b, Winston Salem, NC 27104-4880 | 2020-01-29 |
| 1043876493 | Home Again Senior Living Communities, LLC | Recreation Therapist | 1348 Westgate Center Dr, Winston Salem, NC 27103-2984 | 2019-05-10 |
| 1578037073 | Family First Physical Therapy L.L.C. | Recreation Therapist | 2726 Barringer Dr, Charlotte, NC 28208-7008 | 2019-01-17 |
| 1629593454 | Wesley Tyler | Recreation Therapist | 9139b Trinity Rd, Charlotte, NC 28216-1900 | 2017-08-14 |
| 1962923474 | Vernice Dolores Gallon Clyburn | Recreation Therapist | 126 S Rose Ave, Kannapolis, NC 28083-3552 | 2017-07-06 |
| 1316334618 | Shannon O'rawe | Recreation Therapist | 1707 Waterclose Ct, Apex, NC 27502-6264 | 2015-04-24 |
| 1073928685 | Allison Westpfahl | Recreation Therapist | 1208 Ben Williams Rd, Richlands, NC 28574-5128 | 2014-06-23 |
| 1467722736 | Melissa Sue Walker | Recreation Therapist | 6213 Lowergate Dr, Waxhaw, NC 28173-6747 | 2012-01-04 |
| 1881971174 | Melissa Hunt Lewis | Recreation Therapist | 4907 Creekside Dr, New Bern, NC 28562-5007 | 2011-11-15 |
| 1992002893 | Lois Stanga Harvin | Recreation Therapist | 1607 Temple St Sw, Valdese, NC 28690-9330 | 2011-02-12 |
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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.