Individual provider Active NPI

Caitlin Ann McCormick, ARNP

  • Primary Care Nurse Practitioner
  • Branford, CT
National Provider Identifier
1417598186
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1102882 Issued in FL
Practice address
1204 Main St Ste 576
Branford, CT 06405-3787
Phone
(844) 359-8363
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1102882 FL Primary

Addresses

Primary practice location

1204 Main St Ste 576
Branford, CT 06405-3787

Mailing address

601 N 12TH St Apt 201
Tampa, FL 33602-3194

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200124000778 SC Practitioner - Nurse Practitioner 2769817519 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23158SCMDGynecology Physician
1102882FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PH Health Care Services Inc CurrentSince May 7, 2024 Accepting new patients
Medcare Urgent Care Center - Anderson LLC CurrentSince Nov 23, 2020 Accepting new patients
Medcare Express - North Charleston LLC CurrentSince Nov 23, 2020 Accepting new patients

Locations

8740 Rivers Ave
North Charleston, SC 29406
Phone (843) 337-2406

8720 Dorchester Rd
North Charleston, SC 29420
Phone (843) 552-3629

Organizations & group practices 3

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": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1417598186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N 12TH ST APT 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 MAIN ST STE 576",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053787",
            "telephone_number": "844-359-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "CAITLIN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "1102882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

Verify at the official NPI Registry.