1. Home
  2. Directory
  3. Ohio
  4. Dayton
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

DR. SAMUEL CORNWELL MD
NPI 1104629328
Student in an Organized Health Care Education/Training Program in Dayton, OH

Active since March 31, 2025PECOS Enrolled
30 E APPLE ST FL 6, DAYTON, OH 45409(937) 208-2004 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Samuel Cornwell Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMUEL CORNWELL MD (NPI 1104629328) is an individual student in an organized health care education/training program in Dayton, Ohio and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104629328
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. SAMUEL CORNWELLCredential: MD
Location Address30 E APPLE ST FL 6Dayton, OH 45409-2939
Mailing Address30 E Apple St Fl 6Dayton, OH 45409-2939
Phone(937) 208-2004
Sole ProprietorNo
Enumeration DateMarch 31, 2025
NPPES CertifiedMarch 31, 2025
✔ NPI 1104629328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
30 E APPLE ST FL 6, Dayton, OH 45409
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samuel Cornwell Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AQSA AHMED DO
Student in an Organized Health Care Education/Training Program
30 E APPLE ST FL 6
DAYTON, OH 45409
Montgomery County (937) 208-2004
DANIEL RAJAEE DO
Student in an Organized Health Care Education/Training Program
30 E APPLE ST FL 6
DAYTON, OH 45409
Montgomery County (937) 208-2004
LABEEB AHMAD MD
Student in an Organized Health Care Education/Training Program
30 E APPLE ST FL 6
DAYTON, OH 45409
Montgomery County (937) 208-2004
RABIYA JANDARAN MD
Student in an Organized Health Care Education/Training Program
30 E APPLE ST FL 6
DAYTON, OH 45409
Montgomery County (937) 208-2004
CHLOE SYNCLAIRE GROVE MD
Internal Medicine
30 E APPLE ST FL 6
DAYTON, OH 45409
Montgomery County (937) 208-2866
DR. ARHAM MOHD SIDDIQUI DO
Student in an Organized Health Care Education/Training Program
30 E APPLE ST FL 6
DAYTON, OH 45409
Montgomery County (937) 208-2004
DR. MAMUR AHMED CHOWDHURY DO
Student in an Organized Health Care Education/Training Program
30 E APPLE ST FL 6
DAYTON, OH 45409
Montgomery County (937) 208-2004
DR. NICKLAUS LEWIS BROWN MD
Internal Medicine
30 E APPLE ST FL 6
DAYTON, OH 45409
Montgomery County (937) 208-2004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Cornwell's NPI number?

The NPI number for Samuel Cornwell is 1104629328. It was assigned to this individual provider in the NPPES registry on March 31, 2025.

Where is Samuel Cornwell located?

Samuel Cornwell practices at 30 E Apple St Fl 6, Dayton, OH 45409. The listed phone number is (937) 208-2004.

What is Samuel Cornwell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samuel Cornwell enrolled in Medicare?

Yes. Samuel Cornwell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samuel Cornwell was last updated on March 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.