Individual provider Active NPI

Connor James McCormick, MD

  • Psychiatry Physician
  • Dearborn, MI
National Provider Identifier
1386495851
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301517566 Issued in MI
Practice address
18001 Rotunda Dr
Dearborn, MI 48124-3984
Phone
(947) 522-3088
NPI assigned
Apr 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301517566 MI Primary

Addresses

Primary practice location

18001 Rotunda Dr
Dearborn, MI 48124-3984

Mailing address

18001 Rotunda Dr
Dearborn, MI 48124-3984
Phone (947) 522-3088

Other practice location 1

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (847) 521-8000

Other identifiers 2

IdentifierTypeStateIssuer
4301517566OtherMILARA PHYSICIAN LICENSE
5315265162OtherMILARA CONTROLLED SUBSTANCE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmccormick2128572@epic00.corewelldirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240612000294 MI Order and Referring Only - PsychiatryPractitioner - Psychiatry 4284176736

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26901 Beaumont Blvd
Southfield, MI 48033-3849

855 S Main St
Royal Oak, MI 48067-3278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1386495851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 ROTUNDA DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243984",
            "telephone_number": "947-522-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 ROTUNDA DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243984",
            "telephone_number": "947-522-3088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "847-521-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "CONNOR",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-01",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301517566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LARA PHYSICIAN LICENSE",
            "identifier": "4301517566",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LARA CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315265162",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmccormick2128572@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "28050 Grand River Ave",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483365919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.