Carl Preston McCormack, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E-12101 Issued in AR

Practice address

1001 N University Ave Ste 150
Little Rock, AR 72207-6369

Phone

(501) 361-3249

NPI assigned

Mar 28, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 26, 2024 through Jan 26, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: carl.mccormack@482083011166212.direct.elationemr.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1013301936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N UNIVERSITY AVE STE 150",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722076369",
            "telephone_number": "501-361-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N UNIVERSITY AVE STE 150",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722076369",
            "telephone_number": "501-361-3249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Way # 653",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722023500",
            "country_code": "US",
            "telephone_number": "501-364-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "CARL",
        "middle_name": "PRESTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-28",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-12101",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-12101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey C McConnell
• Zachary McConnell
• Mary Kathryn McCool, AGACNP-BC
• Megan McCorkindale, PHARMD
• Karen McCorkle, LPN
• Alice Elizabeth McCormick
• Elizabeth Shae McCormick, PHARM D
• Griffin Bentley McCowan, CRNA
• Timothy McCowan, MD
• Amber McCoy

• Internal Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.