McCormack Plastic Surgery

Primary specialty

SpecialistTaxonomy code 174400000X

License

12004 Issued in NV

Legal business name

MCCORMACK PLASTIC SURGERY

Practice address

10791 Double R Boulevard
Reno, NV 89521

Phone

(775) 284-2020

Fax

(775) 284-2023

NPI assigned

Jul 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Tiffany D McCormack, MD

Title

Presidient

Phone

(775) 284-2020

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1265698328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10791 DOUBLE R BOULEVARD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89521",
            "telephone_number": "775-284-2020",
            "fax_number": "775-284-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10791 DOUBLE R BOULEVARD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89521",
            "telephone_number": "775-284-2020",
            "fax_number": "775-284-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCORMACK PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "MCCORMACK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDIENT",
        "authorized_official_telephone_number": "775-284-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NV",
            "license": "12004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1083789481",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100513000",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda Esther McConnell-Kelly
• James McConnell
• Justin McConnell, PHARM D
• Melissa Anne McCool, DDS
• Dean Michael McCorkle, CADC INTERN
• McCormack Surgery Center
• Brian J McCormack, MD
• Marie Monique McCormack, MD
• Matthew C McCormack, M.D.
• Tiffany D McCormack, M.D.

• Specialist in Reno, NV
• Providers in Reno, NV by specialty
• Specialist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.