Cory McCormick, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CORY MCCORMICK, LLC

Practice address

710 13TH Ave S
Jacksonville, FL 32250-5032

Phone

(904) 322-3475

NPI assigned

May 13, 2024

Organization subpart

No

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

Authorized official

Name

Cory Lee McCormick, ARNPNPI 1861940819

Title

Owner

Phone

(904) 322-3475

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cory Lee McCormick, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville Beach, FL
  • NPI 1861940819

  FL, Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official
• Vanessa Jaclyn Wilczak, D.C.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1366775124
  NPD

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1043069115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 13TH AVE S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322505032",
            "telephone_number": "904-322-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 13TH AVE S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322505032",
            "telephone_number": "904-322-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORY MCCORMICK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-322-3475",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Elizabeth Cortese, DO
• Anthony Cortez
• Valerie Cortez
• Isabel Oliva Cortopassi, M.D.
• Eduardo Corvison, RN
• Christie Cosby, OTR
• Lynn Cosentino, MD
• Liz Villanueva Cosep, PT
• Bethany O'Connor Cosgrove, M.S. CCC-SLP
• Emilio Cosio, D.C.

• All providers in Jacksonville, FL
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.