Debra J McCormack, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0051488 Issued in CO

Practice address

729 E Spaulding Ave
Pueblo West, CO 81007-3512

Phone

(719) 547-9119

Fax

(719) 547-7555

NPI assigned

Dec 20, 2005

Last updated

Aug 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Magnolia Healthcare, LLC

  dba Vital Care of Auburn

  • Home Infusion Therapy Pharmacy
  • Auburn, AL
  • NPI 1497416739
  NPD (past)
• Primary Medicine Associates, LLC

  • Family Medicine Physician
  • Auburn, AL
  • NPI 1407099286
  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1013993187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 E SPAULDING AVE",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810073512",
            "telephone_number": "719-547-9119",
            "fax_number": "719-547-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 E SPAULDING AVE",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810073512",
            "telephone_number": "719-547-9119",
            "fax_number": "719-547-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "DEBRA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "27445",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0051488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38673533",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01100409",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00344585",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "51535235",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9939616",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary C. Martino, AU.D
• Maulin Medical LLC
• Nina Maurello, MSW
• Laura Lynn Maynes Cortez, MSW
• Amanda McBeain
• James W McCullough, MD
• Sharon Camiray McDougal, CPM, RM
• Jacqueline Marie McHenry-Hascek
• Lynette Melgosa
• Mental Health Transitional Living Home (MHTL) (Mental Health Transitional Living Home Bayfield)

• Family Medicine Physician in Pueblo West, CO
• Providers in Pueblo West, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.