Individual provider Active NPI

Michael McCorkle, D.C.

  • Chiropractor
  • West Chester, PA
National Provider Identifier
1679061964
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011367 Issued in PA
Practice address
796 Scattergood LN
West Chester, PA 19380-1644
Phone
(610) 496-5200
NPI assigned
Apr 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC011367 PA Primary

Addresses

Primary practice location

796 Scattergood LN
West Chester, PA 19380-1644

Mailing address

796 Scattergood LN
West Chester, PA 19380-1644
Phone (610) 496-5200

Other practice location 1

3547 Rhoads Ave
Newtown Square, PA 19073-3624
Phone (610) 356-2341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180604002283 PA Practitioner - Chiropractic 5092070565 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC011367PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
KJ Healthcare Group LLC Chiropractor CurrentSince May 1, 2018 Accepting new patients

Locations

3547 Rhoads Ave
Newtown Square, PA 19073
Phone (610) 356-2341

Organizations & group practices 1

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": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1679061964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "796 SCATTERGOOD LN",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193801644",
            "telephone_number": "610-496-5200",
            "fax_number": "610-431-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "796 SCATTERGOOD LN",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193801644",
            "telephone_number": "610-496-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3547 Rhoads Ave",
            "address_purpose": "LOCATION",
            "city": "Newtown Square",
            "state": "PA",
            "postal_code": "190733624",
            "country_code": "US",
            "telephone_number": "610-356-2341",
            "fax_number": "610-356-3763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORKLE",
        "first_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; 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.