DR. DARRELL R. CORNELIUS (NPI# 1639270812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639270812 |
| Entity Type | Individual |
| Full Name | DR. DARRELL R. CORNELIUS |
| Credential | MD |
| Practice Address |
1311 E. Division Street Mount Vernon WA 98274 |
| Mailing Address |
1400 E. Kincaid Street Mount Vernon WA 98274-4127 |
| Practice Telephone | 3604247991 |
| Practice Fax Number | 3604284377 |
| Mailing Telephone | 3604282500 |
| Mailing Fax Number | 3604286485 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2011-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | MD2086 | AK | Allopathic & Osteopathic Physicians |
| Y | 208800000X | Urology | MD00018397 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD2086 | 05 | |
| WA | 1646405 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427406644 | Darrell Cornelius | Hearing Instrument Specialist | 510 Bering Dr, Suite 364, Houston, TX 77057-1457 | 2016-05-27 |
| Street Address |
1311 E. DIVISION STREET |
| City | MOUNT VERNON |
| State | WA |
| Zip Code | 98274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104842103 | Laurence M. Lee | Urology | 1311 E. Division Street, Mount Vernon, WA 98274 | 2006-07-14 |
| 1003066432 | Courtney A. Shick | Physician Assistant | 1311 E. Division Street, Mount Vernon, WA 98274 | 2008-09-22 |
| 1821183856 | Amy M. Arisco | Urology | 1311 E. Division Street, Mount Vernon, WA 98274 | 2006-10-04 |
| 1376637629 | Winston G. Jones | Urology | 1311 E. Division Street, Mount Vernon, WA 98274 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123438 | Ankur Tarun Sanghvi | Peer Specialist | 209 Milwaukee Steet, 209, Mount Vernon, WA 98274 | 2017-06-07 |
| 1932647187 | Claudia Diaz | Counselor | 23550 Garden St, Mount Vernon, WA 98274 | 2017-02-08 |
| 1871042002 | Richard Simcock Dds, Ps | Dentist | 130 S 15th St Suite 101, Mount Vernon, WA 98274 | 2016-09-29 |
| 1528228186 | Parampreet Singh Ghuman | Internal Medicine | 121 S. 12th St, Ste B, Mount Vernon, WA 98274 | 2008-06-16 |
| 1699940874 | Eugene Villanueva De Guzman | Internal Medicine | 208 S Hospital Pkwy, Mount Vernon, WA 98274 | 2008-04-28 |
| 1871775122 | Matthew John Novak | Internal Medicine | 208 Hospital Pkwy, Mount Vernon, WA 98274 | 2007-11-28 |
| 1568658797 | Emily A K Bianconi | Nurse Practitioner | 2101 Little Mountain Lane, Mount Vernon, WA 98274 | 2007-09-21 |
| 1659576981 | Peggy Randall | Counselor | 1420 S 12th, Mount Vernon, WA 98274 | 2007-06-18 |
| 1194937037 | Cascade Neurologic Clinic, Inc, P.s. | Clinic/Center | 1315 East Division St., Mt. Vernon, WA 98274 | 2007-05-04 |
| 1427171297 | Keri L D Halgren | Dentist | 1711 E Division Street, Mt Vernon, WA 98274 | 2007-04-09 |
| Find all providers in zip 98274 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750631891 | Marc Janis Md Pllc | Urology | 150 Stevens Ave, Suite 109, Mount Vernon, NY 10550-2596 | 2012-09-17 |
| 1578755211 | Cooper Urology, Inc. Ps | Urology | 1611 Buck Way, Mount Vernon, WA 98273-2596 | 2007-08-16 |
| 1104842103 | Laurence M. Lee | Urology | 1311 E. Division Street, Mount Vernon, WA 98274 | 2006-07-14 |
| 1407841562 | Northwest Urology Clinic Inc | Urology | 1311 E Division St, Mount Vernon, WA 98274-4134 | 2005-09-14 |
| 1881699908 | David R Knowles | Urology | 4109 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2005-06-15 |
| 1447778642 | Adit Shah | Urology | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2017-09-07 |
| 1457693244 | Richard Von Ho | Urology | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2013-03-20 |
| 1104085588 | Commonweath Urology Psc | Urology | 145 Newcomb Ave, Mount Vernon, KY 40456-2728 | 2008-06-02 |
| 1003937947 | Sandra Jane Hadjinian | Urology | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2007-04-02 |
| 1720166812 | Eugene Kee Hong | Urology | 1400 E. Kincaid Street, Skagit Regional Clinics-urology, Mount Vernon, WA 98274 | 2006-11-02 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 98274 |
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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.