Individual provider Active NPI

Erin McCormick

  • Clinic/Center
  • Chester, PA
National Provider Identifier
1174995690
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
RT004470 Issued in PA
Practice address
1 Medical Center Blvd
Pob II Suite 324
Chester, PA 19013-3902
Phone
(610) 876-0347
Fax
(610) 876-4343
NPI assigned
Oct 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X RT004470 PA Primary

Addresses

Primary practice location

1 Medical Center Blvd
Pob II Suite 324
Chester, PA 19013-3902

Mailing address

1 Medical Center Blvd
Pob II Suite 324
Chester, PA 19013-3902
Phone (610) 876-0347

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RT004470PAMDClinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1174995690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "POB II SUITE 324",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-876-0347",
            "fax_number": "610-876-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "POB II SUITE 324",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-876-0347",
            "fax_number": "610-876-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "ERIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "RT004470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.