Charles Keith McCord, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22512 Issued in CA

Practice address

16850 Bear Valley Rd
Victorville, CA 92395-5794

Phone

(760) 241-8000

Fax

(760) 962-8021

NPI assigned

Sep 14, 2012

Last updated

Jan 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metropolitan Hospital AuthorityGroup PAC ID 3779775432, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Metro Nashville General Hospital Hospital, Nashville, TN, CCN 440111

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Metropolitan Hospital Authority

  • Multi-Specialty Clinic/Center
  • Nashville, TN
  • NPI 1710206156
  Medicare reassignment Care Compare group
• Crossroads Urgent Care PLLC

  dba Urgent Team

  • Family Medicine Physician
  • Murfreesboro, TN
  • NPI 1366644361

  Physician Assistant

  Medicare reassignment NPD
• Meharry Medical College

  dba Meharry Medical Group

  • Clinic/Center
  • Nashville, TN
  • NPI 1205859279
  Medicare reassignment
• Crossroads Urgent Care PLLC

  dba Urgent Team

  • Rural Health Clinic/Center
  • South Pittsburg, TN
  • NPI 1427781129

  Physician Assistant

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nashville General Hospital

  dba Metropolitan Nashville General Hospital

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1568551455
  Care Compare affiliation

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1215287420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 DR DB TODD JR BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372083501",
            "telephone_number": "615-327-5944",
            "fax_number": "615-327-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16850 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955794",
            "telephone_number": "760-241-8000",
            "fax_number": "760-962-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORD",
        "first_name": "CHARLES",
        "middle_name": "KEITH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-14",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber C McCarter, FNP-C
• Glenda McCauley
• Tess McClellan
• Yvonne Monique McCombs
• Michael McConnell, D.O.
• Miranda McCormack
• Nimi McCoy, RPH
• Jada Rayshill McCullough
• Quincy Eugene McCullough
• Antoinette McCully

• Physician Assistant in Victorville, CA
• Providers in Victorville, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.