NPIMap

Individual provider Active NPI

M E McCormick, D.O.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Farmington Hills, MI
National Provider Identifier
1093785776
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
010260 Issued in MI
Practice address
28595 Orchard Lake Rd
Suite 200
Farmington Hills, MI 48334-2977
Phone
(248) 553-0010
Fax
(248) 553-0818
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 010260 MI Primary

Addresses

Primary practice location

28595 Orchard Lake Rd
Suite 200
Farmington Hills, MI 48334-2977

Mailing address

28595 Orchard Lake Rd
Suite 200
Farmington Hills, MI 48334-2977
Phone (248) 553-0010

Other identifiers 1

IdentifierTypeStateIssuer
3268772MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmccormick66370@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
010260MIMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William Beaumont Hospital Past Accepting new patients
Glendale Neurological Associates P C PastSince Aug 20, 2001 Accepting new patients
West Michigan Aas LLC PastSince Jan 26, 2026 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmccormick66370@direct.beaumont.edu
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1697

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1093785776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28595 ORCHARD LAKE RD",
            "address_2": "SUITE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342977",
            "telephone_number": "248-553-0010",
            "fax_number": "248-553-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28595 ORCHARD LAKE RD",
            "address_2": "SUITE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342977",
            "telephone_number": "248-553-0010",
            "fax_number": "248-553-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "M",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MI",
            "license": "010260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3268772",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmccormick66370@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "28595 Orchard Lake Rd",
            "address_2": "Suite 200",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483342977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.