Individual provider Active NPI

Timothy I McCord, D.P.M.

  • Podiatrist
  • Everett, WA
National Provider Identifier
1306827795
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO00000371 Issued in WA
Practice address
3401 Rucker Ave
Everett, WA 98201-4281
Phone
(425) 259-3757
Fax
(425) 259-6565
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO00000371 WA Primary

Addresses

Primary practice location

3401 Rucker Ave
Everett, WA 98201-4281

Mailing address

3401 Rucker Ave
Everett, WA 98201-4281
Phone (425) 259-3757

Other identifiers 1

IdentifierTypeStateIssuer
1014315MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100324000525 WA Practitioner - Podiatry 5799810172 Reassigns benefits to 1 organization
Practice locations: Everett, WA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Everett Foot Clinic PLLCGroup PAC ID 8123423548, 2 clinicians

Practice addresses (Care Compare)

3401 Rucker Ave
Everett, WA 98201-4281
Phone (425) 259-3757

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue43
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Everett Foot Clinic PLLC Podiatrist CurrentSince Aug 27, 2020 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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1306827795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014281",
            "telephone_number": "425-259-3757",
            "fax_number": "425-259-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014281",
            "telephone_number": "425-259-3757",
            "fax_number": "425-259-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORD",
        "first_name": "TIMOTHY",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014315",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.