Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson Tuley Cornelison

Individual provider Family Medicine Physician · NPI 1154929131

Jackson Tuley Cornelison is a Nurse Practitioner in Birmingham, Alabama. Graduated from University of Alabama School of Medicine in 2020, 6 years ago. Practices with University of Alabama Health Services Foundation, PC, a 2,759-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Alabama.

Years since qualifying
6
Trained at
University of Alabama School of Medicine
Licensed in
AL
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

619 19th St S
Birmingham, AL 35249-2338
Phone: (205) 934-4011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1201 11th Ave S, Birmingham, AL 35205-3423 — (205) 930-7790

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 1-160696 (AL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 1-160696 (AL)

Record details

NPI number1154929131
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 13, 2020
Last updated in NPPESJune 30, 2023
Certification dateAugust 15, 2022
Mailing addressPo Box 55310, Birmingham, AL 35255-5310

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice University Of Alabama Health Services Foundation, Pc — 2759 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Birmingham