Individual provider Active NPI

Carol Ross-McCormick, RN, NP

  • Nephrology Physician
  • Fresno, CA
National Provider Identifier
1194962266
Registry record updated Jun 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
483915 Issued in CA
Practice address
568 E Herndon Ave
Suite 201
Fresno, CA 93720-2989
Phone
(559) 228-6600
Fax
(559) 226-3709
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Registered Nurse 163WN0300X 483915 CA
Nephrology Physician 207RN0300X 483915 CA Primary

Addresses

Primary practice location

568 E Herndon Ave
Suite 201
Fresno, CA 93720-2989

Mailing address

7202 N Millbrook Ave
Ste 105
Fresno, CA 93720-3341
Phone (559) 228-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090206000505 CA Practitioner - Nurse Practitioner 3476618489 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
18502CAMDClinical Social Worker
483915CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reddy Medical Group Inc CurrentSince Jun 9, 2017 Accepting new patients
The Nephrology Group, Inc. Nephrology CurrentSince Jan 15, 2009 Accepting new patients
The Nephrology Group, Inc. Clinical Lab CurrentSince Jan 15, 2009 Accepting new patients

Locations

7202 N Millbrook Ave
Ste 105
Fresno, CA 93720
Phone (559) 450-4463

568 E Herndon Ave
Ste 201
Fresno, CA 93720
Phone (559) 228-9660

7045 N Maple Ave
Ste 101
Fresno, CA 93720
Phone (559) 326-7393

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": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1194962266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7202 N MILLBROOK AVE",
            "address_2": "STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203341",
            "telephone_number": "559-228-6600",
            "fax_number": "559-226-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 E HERNDON AVE",
            "address_2": "SUITE 201",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202989",
            "telephone_number": "559-228-6600",
            "fax_number": "559-226-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS-MCCORMICK",
        "first_name": "CAROL",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nephrology",
            "state": "CA",
            "license": "483915",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "483915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.