Individual provider Active NPI

Caren Michelle Coffy-McCormick, APRN

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Middletown, DE
National Provider Identifier
1043461627
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
LE-0000176 Issued in DE
Practice address
292 Carter Dr
Suite B
Middletown, DE 19709-5846
Phone
(302) 449-0710
Fax
(302) 449-1770
NPI assigned
Oct 1, 2008
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X LE-0000176 DE Primary

Addresses

Primary practice location

292 Carter Dr
Suite B
Middletown, DE 19709-5846

Mailing address

292 Carter Dr
Suite B
Middletown, DE 19709-5846
Phone (302) 449-0710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100326000976 DE Practitioner - Nurse Practitioner 0446386676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McCormick and Associates of Middletown, LLCGroup PAC ID 5294905162, 2 clinicians

Practice addresses (Care Compare)

5350 Summit Bridge Rd
Middletown, DE 19709-4802
Phone (302) 449-0710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1043461627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 CARTER DR",
            "address_2": "SUITE B",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095846",
            "telephone_number": "302-449-0710",
            "fax_number": "302-449-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 CARTER DR",
            "address_2": "SUITE B",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095846",
            "telephone_number": "302-449-0710",
            "fax_number": "302-449-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFY-MCCORMICK",
        "first_name": "CAREN",
        "middle_name": "MICHELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "DE",
            "license": "LE-0000176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, DE

Sources for this page

Verify at the official NPI Registry.