Keith Dean McCormick, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

214956 Issued in AK

Practice address

3201 C St Ste 606
Anchorage, AK 99503-3971

Phone

(907) 441-7781

NPI assigned

Aug 18, 2022

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 AK

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

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 and National Provider Directory roles.

• Medical Network of Alaska, LLC

  • Urgent Care Clinic/Center
  • Wasilla, AK
  • NPI 1538414834
  Medicare reassignment
• Sra D.O. LLC

  • Child & Adolescent Psychiatry Physician
  • Anchorage, AK
  • NPI 1164166088
  Medicare reassignment
• Medical Network of Alaska, LLC

  • Orthopaedic Surgery Physician
  • Anchorage, AK
  • NPI 1326753021
  NPD
• Medical Network of Alaska, LLC

  • Clinical Medical Laboratory
  • Wasilla, AK
  • NPI 1467167585
  NPD
• Medical Network of Alaska, LLC

  • Otolaryngology Physician
  • Anchorage, AK
  • NPI 1922862986
  NPD
• Medical Network of Alaska, LLC

  • Specialist
  • Wasilla, AK
  • NPI 1508089046
  NPD (past)

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1245958024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 C ST STE 606",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033971",
            "telephone_number": "907-441-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 C ST STE 606",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033971",
            "telephone_number": "907-441-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "KEITH",
        "middle_name": "DEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "214956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rollin Byron McCord, MD
• Brian McCorison
• Jill McCormick, REGISTERED NURSE
• John McCormick, M.D.
• Julie McCormick, M.D.
• Madeline Riley McCormick
• Madison Lee McCormick
• Vivien McCormick, CNA
• Sondra M McCotter
• John David McCoy Jr.

• Physician Assistant in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.