MR. MICHAEL PAT CORNWALL (NPI# 1427117381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427117381 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL PAT CORNWALL |
| Credential | NURSE PRACTITIONER |
| Practice Address |
4646 Nine Mile Point Rd Fairport NY 14450-1163 |
| Mailing Address |
2416 East Ave Rochester NY 14610-2525 |
| Practice Telephone | 5853770350 |
| Mailing Telephone | 5854424156 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
F301165-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD PROVIDER NUMBER | 500006563 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376194134 | Michael Charles Cornwall | Pharmacist | 21 Shallowbrook Dr, O Fallon, IL 62269-1214 | 2019-09-24 |
| 1114313350 | Michael Cornwall | Marriage & Family Therapist | 121 W J St, Benicia, CA 94510-3165 | 2015-04-14 |
| 1184921033 | Michael Cornwall | Counselor | 1001 Windsor Dr, Shelbyville, KY 40065-7378 | 2011-02-11 |
| Street Address |
4646 NINE MILE POINT RD |
| City | FAIRPORT |
| State | NY |
| Zip Code | 14450-1163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255321345 | Bonnie R Crawford | Nurse Practitioner | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2005-10-28 |
| 1922592104 | Julie Anne Moretti | Occupational Therapist | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2018-06-20 |
| 1578089637 | Katherine Corbett | Physical Therapist | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2017-08-20 |
| 1609268812 | Julie Seither | Physical Therapist | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2015-02-25 |
| 1164813192 | Diane Hartley | Occupational Therapist | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2015-02-12 |
| 1215328786 | Teresa Bergin | Physical Therapist | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2015-02-05 |
| 1164813655 | Tracy Murphy | Physical Therapist | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2015-02-05 |
| 1689065195 | Marielle Jensen-battaglia | Physical Therapist | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2015-02-05 |
| 1659761146 | Jody Illingworth | Physical Therapist | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2015-02-04 |
| 1093047656 | Nicholas Theodorou | Pharmacist | 4646 Nine Mile Point Rd, Fairport, NY 14450-1163 | 2010-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982255899 | Stephanie Janet Catlin-rakoski | Counselor | 1387 Fairport Rd Bldg 500, Ste 540, Fairport, NY 14450 | 2019-09-23 |
| 1477011773 | Meredith Noel Austin-appleton | Pediatrics | Pediatric Urgent Care of Rochester, 6687 Pittsford Palmyra Rd, Fairport, NY 14450 | 2019-03-05 |
| 1659852358 | Linda Demme | Registered Nurse | 29 Pleasant St, Fairport, NY 14450 | 2018-08-22 |
| 1679075154 | Tharaha Thavakumar | Behavior Technician | 6 N. Main Street, Fairport, NY 14450 | 2018-03-01 |
| 1295244309 | Comprehensive Medicine, Pllc | Psychiatry & Neurology | 762 Crosskeys Office Park, Fairport, NY 14450 | 2017-09-21 |
| 1104353846 | Courtney Chapman | Student in an Organized Health Care Education/Training Program | 4 Valais Ct, Fairport, NY 14450 | 2017-05-12 |
| 1477947786 | Preston Orthodontics, Pllc | Dentist | 2154 Fairport Nine Mile Point Road, Fairport, NY 14450 | 2015-03-25 |
| 1154724334 | Amanda Corrisa Kalsih | Registered Nurse | 95 Evergreen Circle, Fairport, NY 14450 | 2014-10-02 |
| 1295172153 | Pamela Lea Alexander | Skilled Nursing Facility | 41 O,connor Road, Monroe #1 Boces, Fairport, NY 14450 | 2013-05-31 |
| 1255682084 | Lauren Lashomb | Specialist | 6 North Main Street, Fairport, NY 14450 | 2012-09-19 |
| Find all providers in zip 14450 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942648464 | Beth Louise Carpenter | Nurse Practitioner | 14 Pleasant St, Fairport, NY 14450-1510 | 2013-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427871 | Tammie Kae Copp | Nurse Practitioner | 8266 Casson Rd, Lindley, NY 14858-9697 | 2020-11-08 |
| 1770184673 | Annette Virosami | Nurse Practitioner | 890 Trinity Ave Apt 8d, Bronx, NY 10456-7419 | 2020-11-06 |
| 1972104958 | Jonathan Dillera Nietes | Nurse Practitioner | 4411 Macnish St Apt 1g, Elmhurst, NY 11373-3609 | 2020-11-05 |
| 1407457088 | Sanjana Kumari | Nurse Practitioner | 62 Albertson Pl, Mineola, NY 11501-4601 | 2020-11-02 |
| 1780284927 | Hannah Catan | Nurse Practitioner | 473 W 158th St Apt 10, New York, NY 10032-5361 | 2020-10-27 |
| 1700486248 | Amandeep Kaur | Nurse Practitioner | 7638 270th St, New Hyde Park, NY 11040-1418 | 2020-10-26 |
| 1861091324 | Stacey M Jantsch | Nurse Practitioner | 8237 Cicero Mills Rd, Cicero, NY 13039-8344 | 2020-10-25 |
| 1871192468 | Adult Health Np House Calls, PC | Nurse Practitioner | 7954 Transit Rd # 134, Williamsville, NY 14221-4117 | 2020-10-23 |
| 1104425891 | Tze-hsuan Chao | Nurse Practitioner | 3916 Prince St Ste 257, Flushing, NY 11354-5367 | 2020-10-22 |
| 1992304968 | Nicholas Robinson | Nurse Practitioner | 295 Essjay, Williamsville, NY 14221 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
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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.