John M McCormack, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

R3B70 Issued in MO

Practice address

805 Kentucky Ave.
West Plains, MO 65775

Phone

(417) 256-2111

Fax

(417) 256-4858

NPI assigned

Jun 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johnmccormack@bcm.allscriptsdirect.net

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.

• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Van Buren, MO
  • NPI 1225045321
  Medicare reassignment NPD
• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Ellington, MO
  • NPI 1669575908
  NPD
• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Poplar Bluff, MO
  • NPI 1972466233
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1477558054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 KENTUCKY AVE.",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "65775",
            "telephone_number": "417-256-2111",
            "fax_number": "417-256-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 KENTUCKY AVE.",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "65775",
            "telephone_number": "417-256-2111",
            "fax_number": "417-256-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "R3B70",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00207389",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "599022307",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201249521",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "599022308",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Parker Daniel Matteson, DPT
• Bruce Craig Maxwell, DDS
• Ashley Mayberry
• Deborah June McCart, LCSW
• Johnathan McClure
• Jacob Henry McCrackin
• Carolyn McDaniel
• Emily McDaniel, PT, DPT
• McFarland Spine and Sport LLC
• Heidi McFarland

• General Practice Physician in West Plains, MO
• Providers in West Plains, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.