TYLER A CORNELL, IDC — NPI 1215693759 (Licensed & Credentialed Military Health Care Provider, Independent Duty Corpsman in CAMP LEJEUNE, NC)

CMS-1500 Box 24J / 33a • NPI

1215693759

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

1710I1002X

Licensed & Credentialed Military Health Care Provider, Independent Duty Corpsman

Box 32 Service Location & ZIP+4

PSC 20090, CAMP LEJEUNE, NC, 28542-0090

✓ 9-Digit EDI 837 ZIP+4 (28542-0090)

Practice Phone & Referral Fax

(760) 453-4511

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1215693759 (TYLER A CORNELL, IDC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1215693759` (NPI-1 Individual Practitioner)
Provider / Legal Name	TYLER A CORNELL, IDC
Plain-English Specialty	Licensed & Credentialed Military Health Care Provider, Independent Duty Corpsman NUCC Code: `1710I1002X` (Military Health Care Provider, Independent Duty Corpsman)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	PSC 20090, CAMP LEJEUNE, NC, 28542-0090
Practice Telephone / Fax	Tel: (760) 453-4511
Administrative Mailing Address	120 WALNUT HILLS DR, RICHLANDS, NC, 28574-8346
Enumeration & Last Sync	Enumerated: 2021-11-09 \| CMS Record Updated: 2023-10-24

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

PSC 20090, CAMP LEJEUNE, NC, 28542-0090

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Plain-English Taxonomy & CMS Crosswalk (1710I1002X)

What Does Taxonomy Code 1710I1002X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1710I1002X translates to:
"Licensed & Credentialed Military Health Care Provider, Independent Duty Corpsman"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Military Health Care Provider, Independent Duty Corpsman for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (TYLER A CORNELL, IDC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`1710I1002X` — Military Health Care Provider, Independent Duty Corpsman Plain English: Licensed & Credentialed Military Health Care Provider, Independent Duty Corpsman	State: N/A \| License: `1215693759` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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TYLER A CORNELL, IDC (NPI #1215693759)