Jill Suzanne McCormick, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT36994 Issued in CA

Practice address

2650 Research Park Dr
Soquel, CA 95073-2087

Phone

(831) 566-2004

Fax

(831) 325-0307

NPI assigned

Jun 10, 2005

Last updated

May 3, 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Excel Performance Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • Soquel, CA
  • NPI 1396138715
  Authorized official Same address or phone
• Excel Physical Therapy & Sports Medicine Clinic

  • Physical Therapist
  • Boonville, MO
  • NPI 1609930593
  NPD (past) Authorized official
• Toes on the Go Inc

  dba Toes on the Go

  • Podiatrist
  • Carmel, CA
  • NPI 1124120654
  NPD (past)
• Accelerated Rehabilitation Centers, LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Roscoe, IL
  • NPI 1043604184
  NPD (past)
• Millenium Park Medical Center, SC

  • Chiropractor
  • Chicago, IL
  • NPI 1942538145

  Physical Therapist

  NPD (past)
• Rosenthal Clinic SC

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1942306758
  NPD (past)

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1073517520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WAUGH AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651133",
            "telephone_number": "831-566-2004",
            "fax_number": "831-325-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RESEARCH PARK DR",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732087",
            "telephone_number": "831-566-2004",
            "fax_number": "831-325-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "JILL",
        "middle_name": "SUZANNE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "108639",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070014339",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT36994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "484700802",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracie K Martin, DC
• Ana Martinez
• Susan Matsui, LCSW, PPSC
• MC Surgical LLC
• Lisa Marie McConnell, FNP-BC
• Rebecca McCubbin, RN
• Lynne Karen McGolrick, DC
• Marianna Jane Gabriel Mejia, MFT
• Menm, LLC
• Matt Merrill

• Orthopedic Physical Therapist in Soquel, CA
• Providers in Soquel, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.