JASON R CORNELIUS (NPI# 1982610739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982610739 |
| Entity Type | Individual |
| Full Name | JASON R CORNELIUS |
| Credential | MD |
| Practice Address |
9645 Grove Cir N Ste 100 Maple Grove MN 55369 |
| Mailing Address |
9645 Grove Cir N Ste 100 Maple Grove MN 55369-4466 |
| Practice Telephone | 7633024114 |
| Practice Fax Number | 7633024081 |
| Mailing Telephone | 7633024114 |
| Mailing Fax Number | 7633024081 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2019-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
48590 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICARE RAILROAD | P00733589 | 01 |
| MN | 786463000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9645 Grove Cir N Ste 100, Maple Grove, MN 55369 | 7633024114 | 7633024081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881701563 | Jason Cornelius | Counselor | 90 N 31st, Clinton, OK 73601 | 2006-08-25 |
| Street Address |
9645 GROVE CIR N STE 100 |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912923707 | Yu Zhao | Optometrist | 9645 Grove Cir N Ste 100, Maple Grove, MN 55369-4466 | 2006-07-14 |
| 1396256392 | Jessica Idahor | Family Medicine | 9645 Grove Cir N Ste 100, Maple Grove, MN 55369 | 2017-10-17 |
| 1114241676 | Natalia Semenovna Dorland | Psychiatry & Neurology | 9645 Grove Cir N Ste 100, Maple Grove, MN 55369-4466 | 2010-03-26 |
| 1821155375 | Jamie Witt | Physician Assistant | 9645 Grove Cir N Ste 100, Maple Grove, MN 55369-4466 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114241676 | Natalia Semenovna Dorland | Psychiatry & Neurology | 9645 Grove Cir N Ste 100, Maple Grove, MN 55369-4466 | 2010-03-26 |
| 1659608776 | Northstar Neurological Clinic Ltd | Psychiatry & Neurology | 12000 Elm Creek Blvd, Suite 330, Maple Grove, MN 55369 | 2009-11-10 |
| 1699717561 | Richard Alvin Peterson | Psychiatry & Neurology | 9825 Hospital Dr, Suite 103, Maple Grove, MN 55369-4769 | 2006-06-12 |
| 1992745525 | Charles Haugen Horowitz | Psychiatry & Neurology | 9825 Hospital Dr, Suite 103, Maple Grove, MN 55369-4769 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851905251 | Nexus | Psychiatry & Neurology | 2121 Campus Dr Se, Rochester, MN 55904-4744 | 2020-09-02 |
| 1669995528 | Malik Ghannam | Psychiatry & Neurology | 701 15th Ave Se, Minneapolis, MN 55414-4047 | 2017-07-24 |
| 1477903995 | James Albert Zeese Jr. | Psychiatry & Neurology | 2401 Laurel Avenue, Minneapolis, MN 55405 | 2016-06-15 |
| 1265790414 | Brian Michael Krasnow | Psychiatry & Neurology | 1746 Hillcrest Avenue, Saint Paul, MN 55116-2151 | 2012-04-25 |
| 1699079533 | Gilbert Westreich | Psychiatry & Neurology | 1779 Emerson Ave South, Minneapolis, MN 55403-2909 | 2011-01-07 |
| 1720233570 | West Central Neurology Pa | Psychiatry & Neurology | 11521 312th Ave, Princeton, MN 55371-3423 | 2008-11-20 |
| 1235388521 | Donald W Klass | Psychiatry & Neurology | 956 14th Ave Sw, Rochester, MN 55902-2078 | 2008-09-11 |
| 1598929267 | Frank Wilson Sharbrough IIi | Psychiatry & Neurology | 814 8th Ave Sw, Rochester, MN 55902-6308 | 2008-07-11 |
| 1881855187 | Kenneth James Shea IIi | Psychiatry & Neurology | 3540 17th Ave S, Saint Cloud, MN 56301-9664 | 2008-06-19 |
| 1275792293 | Ali Emami | Psychiatry & Neurology | 310 Smith Ave N Ste 440, Saint Paul, MN 55102-2316 | 2008-06-05 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
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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.