Jackson Tuley Cornelison, is a medicare enrolled "Nurse Practitioner - Acute Care" physician in Birmingham, Alabama. He went to University Of Alabama School Of Medicine and graduated in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice University Of Alabama Health Services Foundation, Pc and his current practice location is
619 19th St S, Birmingham, Alabama. You can reach out to his office (for appointments etc.) via phone at
(205) 934-4011.
Jackson Tuley Cornelison is licensed to practice in Alabama (license number 1-160696) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1154929131.
Physician's Profile
| Full Name | Jackson Tuley Cornelison |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 619 19th St S, Birmingham, Alabama |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jackson Tuley Cornelison attended and graduated from University Of Alabama School Of Medicine in 2020
NPI Data:
- NPI Number: 1154929131
- Provider Enumeration Date: 10/13/2020
- Last Update Date: 06/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 5092126797
- Enrollment ID: I20201202000993
Medical Identifiers
Medical identifiers for Jackson Tuley Cornelison such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1154929131 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 1-160696 (Alabama) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 1-160696 (Alabama) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| University Of Alabama Health Services Foundation, Pc | 1951213107 | 2476 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jackson Tuley Cornelison allows following entities to bill medicare on his behalf.
| Entity Name | University Of Alabama Health Services Foundation, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093768723
PECOS PAC ID: 1951213107
Enrollment ID: O20031105000261 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackson Tuley Cornelison is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jackson Tuley Cornelison,
Po Box 55310,
Birmingham, AL 35255-5310
Ph: (205) 731-9701 | Jackson Tuley Cornelison,
619 19th St S,
Birmingham, AL 35249-2338
Ph: (205) 934-4011 |
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