Individual provider Active NPI

Jane McCormick

  • Family Medicine Physician
  • Martinez, CA
National Provider Identifier
1295817807
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A69931 Issued in CA
Practice address
2500 Alhambra Ave
Martinez, CA 94553-3156
Phone
(925) 370-5110
Fax
(925) 370-5142
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A69931 CA Primary

Addresses

Primary practice location

2500 Alhambra Ave
Martinez, CA 94553-3156

Mailing address

50 Douglas Dr
Suite 391
Martinez, CA 94553-4098
Phone (925) 957-5429

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110627000540 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2062690878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295817807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 DOUGLAS DR",
            "address_2": "SUITE 391",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534098",
            "telephone_number": "925-957-5429",
            "fax_number": "925-957-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ALHAMBRA AVE",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945533156",
            "telephone_number": "925-370-5110",
            "fax_number": "925-370-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A69931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

Verify at the official NPI Registry.