NPIMap

Organization Active NPI

Family Practice Clinic PLC

  • Family Medicine Physician
  • Carlisle, IA
National Provider Identifier
1114912813
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY PRACTICE CLINIC PLC
Practice address
125 School St
Carlisle, IA 50047-8702
Phone
(515) 989-3221
Fax
(515) 989-4518
NPI assigned
Sep 19, 2005
Last updated
Jul 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
Dr. Michael J McCormick, DONPI 1407841653
Title
Owner Physician
Phone
(515) 989-3221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

125 School St
Carlisle, IA 50047-8702

Mailing address

125 School St
PO Box F
Carlisle, IA 50047-0705
Phone (515) 989-3221

Other identifiers 7

IdentifierTypeStateIssuer
DE5916OtherPALMETTO GBA RR MEDICARE
0479345MedicaidIA
07022OtherIAWELLMARK
07022OtherIABLUE SHIELD
124831OtherHEALTH PARTNERS
5656790001OtherIADMERC REGION D
IA0100OtherHERITAGE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1114912813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SCHOOL ST",
            "address_2": "PO BOX F",
            "city": "CARLISLE",
            "state": "IA",
            "postal_code": "500470705",
            "telephone_number": "515-989-3221",
            "fax_number": "515-989-4518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SCHOOL ST",
            "city": "CARLISLE",
            "state": "IA",
            "postal_code": "500478702",
            "telephone_number": "515-989-3221",
            "fax_number": "515-989-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "515-989-3221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RR MEDICARE",
            "identifier": "DE5916",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0479345",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "07022",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "07022",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "124831",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC REGION D",
            "identifier": "5656790001",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HERITAGE",
            "identifier": "IA0100",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.