Active NPI
Matthew Benjamin McCormley
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Jeffersonville, IN
National Provider Identifier
1609694892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 26030487A
- Practice address
- 1027 Jeffersonville Commons Dr
Jeffersonville, IN 47130-8395 - Phone
- (812) 288-9245
- NPI assigned
- Sep 27, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 26030487A | IN | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 023787 | KY |
Addresses
Primary practice location
1027 Jeffersonville Commons Dr
Jeffersonville, IN 47130-8395
Mailing address
1027 Jeffersonville Commons Dr
Jeffersonville, IN 47130-8395
Phone (812) 288-9245
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26030487A | IN | MD | Community/Retail Pharmacy |
| 023787 | KY | MD | Community/Retail Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782432000000",
"number": "1609694892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1027 JEFFERSONVILLE COMMONS DR",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471308395",
"telephone_number": "812-288-9245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1027 JEFFERSONVILLE COMMONS DR",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471308395",
"telephone_number": "812-288-9245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMLEY",
"first_name": "MATTHEW",
"middle_name": "BENJAMIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-27",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "IN",
"license": "26030487A",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "KY",
"license": "023787",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jeffersonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.