Organization Active NPI

Randall McCormick Toledo Internal Medicine Spec Inc

  • Internal Medicine Physician
  • Toledo, OH
National Provider Identifier
1033169685
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RANDALL MCCORMICK TOLEDO INTERNAL MEDICINE SPEC INC
Practice address
2409 Cherry St
Ste 207
Toledo, OH 43608-2625
Phone
(419) 251-7672
Fax
(419) 251-6785
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Randall P McCormick, MD
Title
President
Phone
(419) 251-7672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2409 Cherry St
Ste 207
Toledo, OH 43608-2625

Mailing address

PO Box 505
Toledo, OH 43697-0505
Phone (419) 251-7672

Other identifiers 1

IdentifierTypeStateIssuer
2610302MedicaidOH

National Provider Directory

National Provider Directory

Locations

2409 Cherry St
Ste 207
Toledo, OH 43608
Phone (419) 251-4316

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1033169685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436970505",
            "telephone_number": "419-251-7672",
            "fax_number": "419-251-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 CHERRY ST",
            "address_2": "STE 207",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082625",
            "telephone_number": "419-251-7672",
            "fax_number": "419-251-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL MCCORMICK TOLEDO INTERNAL MEDICINE SPEC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-251-7672",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2610302",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.