MICHAEL CORNWALL PHD LLC
NPI 1699531731
Counselor - Professional in Las Vegas, NV
About Michael Cornwall Phd Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHAEL CORNWALL PHD LLC (NPI 1699531731) is a healthcare organization registered as a professional in Las Vegas, Nevada and active in the NPI registry since February 2024. The organization lists Michael Cornwall, Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Michael Cornwall Phd Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Michael Cornwall Phd LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Michael Cornwall Phd LLC's NPI number?
The NPI number for Michael Cornwall Phd LLC is 1699531731. It was assigned to this organization in the NPPES registry on February 26, 2024.
Where is Michael Cornwall Phd LLC located?
Michael Cornwall Phd LLC is located at 2110 E Flamingo Rd Ste 207, Las Vegas, NV 89119. The listed phone number is (859) 321-4956.
What is Michael Cornwall Phd LLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Michael Cornwall Phd LLC enrolled in Medicare?
Yes. Michael Cornwall Phd LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Michael Cornwall Phd LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Michael Cornwall Phd LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Michael Cornwall Phd LLC was last updated on March 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Michael Cornwall Phd Llc · NPI 1699531731
Professional organization in Las Vegas, Nevada. Organization record, active in the CMS NPPES registry since February 26, 2024.
## Identity
- **NPI:** 1699531731 (Entity type: Organization)
- **Enumerated:** February 26, 2024
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **Organization subpart:** No
- **Authorized official:** Michael Cornwall, PROVIDER
## Practice location
- **Address:** 2110 E FLAMINGO RD STE 207, Las Vegas, NV 89119-5191
- **Phone:** (859) 321-4956 · **Fax:** (702) 472-8635
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Mental Health Counselor) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 2, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1699531731) · Data from the CMS NPPES public registry.