Jennifer McCormack, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP141637 Issued in TX

Practice address

2715 Bolton Boone Dr Ste B
Desoto, TX 75115-2079

Phone

(972) 780-8009

Fax

(972) 780-6115

NPI assigned

May 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Jorge a. Saldivar MD PA

  • Obstetrics & Gynecology Physician
  • Desoto, TX
  • NPI 1295012946
  NPD

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1073170668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 BOLTON BOONE DR STE B",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152079",
            "telephone_number": "972-780-8009",
            "fax_number": "972-780-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 BOLTON BOONE DR STE B",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152079",
            "telephone_number": "972-780-8009",
            "fax_number": "972-780-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "JENNIFER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matrix Specialty Care, PLLC
• Matthew Michael Matusiak, DHSC, MT(ASCP)
• Dawn Mayfield
• Misty R Mays, MPT
• Jeremeka McBride, LCSW
• Lauren Beth McCoy-Maddox
• Leona McCoy
• Kennedy Frances McDaniel, RN, BSN, CNOR, RNFA
• Ashley McDaniels I
• Heather McDowell, MASSAGE THERAPIST

• Family Nurse Practitioner in Desoto, TX
• Providers in Desoto, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.