Kelly R McCormick, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD157529 Issued in OR

Practice address

1600 State St
Salem, OR 97301-4257

Phone

(503) 540-6300

Fax

(503) 540-6404

NPI assigned

May 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Orthopedic Surgery

Education

University of Colorado School of Medicine, Denver, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Salem Hospital Hospital, Salem, OR, CCN 380051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmccormick49841@direct.salemhealth.org

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.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Salem Health

  • Durable Medical Equipment & Medical Supplies
  • Keizer, OR
  • NPI 1487434775

  Orthopaedic Surgery

  NPD
• Campbell Clinic, PC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1003835141
  NPD (past)
• CC Bpci PLC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1881387330
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1629236229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014257",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014257",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5825 Shoreview Ln N",
            "address_purpose": "LOCATION",
            "city": "Keizer",
            "state": "OR",
            "postal_code": "973033978",
            "country_code": "US",
            "telephone_number": "503-540-6471",
            "fax_number": "503-540-6404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "KELLY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MT189201",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD157529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500647558",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Renee McCollum, PSYD
• Pamela Lynn McCollum, LCSW
• Blake McConnell, MD
• Amy McCormick
• Christina Marie McCormick, COTA/L
• Jordan D McCourry, LMT
• Jeffery Scott McCoy, PHARM. D
• Chelsey McCracken
• McCrae Management & Investments, LTD.
• Susan Lee McCrae

• Orthopaedic Surgery Physician in Salem, OR
• Providers in Salem, OR by specialty
• Orthopaedic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.