Active NPI
Michael McCormick, PT, DPT
- Physical Therapist
- Willow Park, TX
National Provider Identifier
1356710636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1195438
- Practice address
- 5141 E. I-20, Service Road North
Willow Park, TX 76087 - Phone
- (817) 441-1971
- Fax
- (817) 441-1266
- NPI assigned
- Sep 17, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1195438 | TX | Primary |
Addresses
Primary practice location
5141 E. I-20, Service Road North
Willow Park, TX 76087
Mailing address
879 Eureka St
Weatherford, TX 76086-5807
Phone (817) 596-8751
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1195438 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Weatherford Texas Hospital Company LLC | Past | Accepting new patients | |
| Vista Physical Therapy LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Denton, TX
- NPI 1699410555
Physical Therapist
-
- Psychiatric Hospital Unit
- Weatherford, TX
- NPI 1346659851
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442448000000",
"number": "1356710636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "879 EUREKA ST",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760865807",
"telephone_number": "817-596-8751",
"fax_number": "817-596-2702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5141 E. I-20, SERVICE ROAD NORTH",
"city": "WILLOW PARK",
"state": "TX",
"postal_code": "76087",
"telephone_number": "817-441-1971",
"fax_number": "817-441-1266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "MICHAEL",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-17",
"last_updated": "2015-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1195438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willow Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.