JUAN A CORNEJO (NPI# 1154374445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154374445 |
| Entity Type | Individual |
| Full Name | JUAN A CORNEJO |
| Credential | MD |
| Practice Address |
4303 Live Oak Drive Little River SC 29566 |
| Mailing Address |
Po Box 547 Little River SC 29566 |
| Practice Telephone | 8436638000 |
| Mailing Telephone | 8436638000 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2015-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 7783 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 007838 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164751525 | Juan Adrian Cornejo | Obstetrics & Gynecology | 2115 Duncan Regional Loop, Duncan, OK 73533-1570 | 2009-12-15 |
| 1740772151 | Juan Pablo Cornejo | Counselor | 3660 Fairmount Ave, San Diego, CA 92105-3422 | 2018-05-31 |
| 1598058521 | Juan Ramon Cornejo Sr. | Counselor | 1001 Potrero Ave., San Francisco, CA 94110-2322 | 2011-05-24 |
| 1952568974 | Juan Carlos Cornejo | Family Medicine | 113 White Horse Rd W, Suite 7, Voorhees, NJ 08043-3672 | 2008-05-19 |
| Street Address |
4303 LIVE OAK DRIVE |
| City | LITTLE RIVER |
| State | SC |
| Zip Code | 29566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215904172 | Dan M Kass | Internal Medicine | 4303 Live Oak Drive, Little River, SC 29566-9138 | 2006-02-28 |
| 1386026193 | Anteo Pashaj | Internal Medicine | 4303 Live Oak Drive, Little River, SC 29566-9138 | 2015-06-29 |
| 1952780447 | Karyn D Asher | Nurse Practitioner | 4303 Live Oak Drive, Little River, SC 29566 | 2015-05-29 |
| 1073922753 | Peggy Bourguillon | Family Medicine | 4303 Live Oak Drive, Little River, SC 29566-9138 | 2014-08-07 |
| 1700107240 | Raymond A. Reiser | Pediatrics | 4303 Live Oak Drive, Little River, SC 29566 | 2010-06-18 |
| 1932327178 | Linda Buster | Nurse Practitioner | 4303 Live Oak Drive, Little River, SC 29566-9138 | 2007-04-23 |
| 1558314914 | Christine M Mcginley | Family Medicine | 4303 Live Oak Drive, Little River, SC 29566 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134736309 | Holly Leanne Poplin | Nurse Practitioner | 3600 Sea Mountain Hwy, Suite C, Main Street Physicians/sc House Calls Inc, Little River, SC 29566 | 2020-09-30 |
| 1619534112 | Mcleod Loris Seacoast Hospital | Pharmacy | 4000 Hwy 9 East, Outpatient Pharmacy, Little River, SC 29566 | 2019-05-21 |
| 1366960585 | Sasha Hayes | Dentist | 1247 Highway 17 S, Little River, SC 29566 | 2017-09-07 |
| 1639557531 | Mary Lucille Harding | Nurse Practitioner | 3600 Sea Mountain Hwy, Suite, Main Street Physicians, Little River, SC 29566 | 2015-05-12 |
| 1770900771 | Dottie Randall-cox | Registered Nurse | 107 Hwy 57-north, Little River, SC 29566 | 2014-03-27 |
| 1689091688 | Carolyn Howe | Registered Nurse | 107 Highway 57 North, Dhec, Little River, SC 29566 | 2014-03-27 |
| 1376977884 | Southern Surgical Group, LLC | Specialist | 3600 Sea Mountain Hwy Suite A, Little River, SC 29566 | 2013-09-03 |
| 1144570888 | Laura Gore | Pharmacist | 2492 Hwy 9 East, Little River, SC 29566 | 2012-09-10 |
| 1255611406 | Belliams Home Health Services | Home Health | 687c Williamson Rd, Longs, SC 29566 | 2011-08-19 |
| 1083878813 | Lacie E. Edmison | Internal Medicine | 3980 Highway 9 E Ste 320, Little River, SC 29566 | 2008-07-10 |
| Find all providers in zip 29566 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999405 | Mcleod Physician Associates II | Family Medicine | 4237 River Hills Dr Ste 170, Little River, SC 29566-6446 | 2020-07-20 |
| 1356870299 | Allie Grace Whitley | Family Medicine | 3980 Highway 9 E Ste 100, Little River, SC 29566-8163 | 2017-06-05 |
| 1811109416 | Catherine Rozario | Family Medicine | 287 Highway 90 E, Unit 6, Little River, SC 29566-7214 | 2007-05-04 |
| 1528105392 | Darron J. Molter | Family Medicine | 3980 Highway 9 E Ste 100a, Little River, SC 29566-8163 | 2007-01-31 |
| 1275670457 | Mary J. Mason | Family Medicine | 3361 Hwy 9 East, Little River, SC 29566-6041 | 2007-01-30 |
| 1326068362 | Chris Boggs | Family Medicine | 4237 River Hills Dr Ste 150, Little River, SC 29566-6446 | 2006-07-20 |
| 1558355388 | George E Berley | Family Medicine | 1300 Highway 17, Little River, SC 29566-9215 | 2005-09-08 |
| 1760481758 | Waterway Family Medicine, Pa | Family Medicine | 3600 Sea Mountain Hwy., Suite C, Little River, SC 29566-7640 | 2005-07-20 |
| 1831197466 | Eston E Williams Jr. | Family Medicine | 3600 Sea Mountain Highway, Suite C, Little River, SC 29566-7640 | 2005-07-08 |
| 1164429825 | Tom A Christensen | Family Medicine | 3600 Sea Mountain Higway, Suite C, Little River, SC 29566 | 2005-07-07 |
| Find all providers in LITTLE RIVER | ||||
| City | LITTLE RIVER |
| Zip Code | 29566 |
Please comment or provide details below to improve the information on JUAN A CORNEJO.
| 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.