Individual provider Active NPI

Jayme Lea McCormick, RADT-1

  • Addiction (Substance Use Disorder) Counselor
  • Vista, CA
National Provider Identifier
1285181529
Registry record updated Sep 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1214560915 Issued in CA
Practice address
504 W Vista Way
Vista, CA 92083-5704
Phone
(760) 940-1836
Fax
(760) 940-1274
NPI assigned
Sep 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1214560915 CA Primary

Addresses

Primary practice location

504 W Vista Way
Vista, CA 92083-5704

Mailing address

504 W Vista Way
Vista, CA 92083-5704
Phone (760) 505-5846

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
R1214560915CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Systems, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1472860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472860800000",
    "number": "1285181529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W VISTA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835704",
            "telephone_number": "760-505-5846",
            "fax_number": "760-940-1274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W VISTA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835704",
            "telephone_number": "760-940-1836",
            "fax_number": "760-940-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "JAYME",
        "middle_name": "LEA",
        "credential": "RADT-1",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-03",
        "last_updated": "2016-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1214560915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2016; 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.