NPIMap

Individual provider Active NPI

Mark O. McCorkindale, MD

  • Family Medicine Physician
  • Wayne, NE
National Provider Identifier
1679528616
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19231 Issued in NE
Practice address
615 E 14TH St
Wayne, NE 68787-1152
Phone
(402) 375-2500
Fax
(402) 375-2463
NPI assigned
May 24, 2006
Last updated
Oct 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19231 NE Primary
Family Medicine Physician 207Q00000X 29362 IA

Addresses

Primary practice location

615 E 14TH St
Wayne, NE 68787-1152

Mailing address

PO Box 328
Sioux City, IA 51102-0328
Phone (712) 279-5830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100527000210 NE Practitioner - Family Practice 9234021742 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Regional Physician Services LLCGroup PAC ID 5193786168, 194 clinicians

Practice addresses (Care Compare)

615 E 14TH St
FRPS Wayne Family Medicine
Wayne, NE 68787-1152
Phone (402) 375-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.77 of 100Reported as group
Quality
67.03
Promoting interoperability
96
Improvement activities
40
Cost
72.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29362IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Regional Physician Services, LLC Family Medicine CurrentSince May 1, 2014 Accepting new patients
Faith Regional Physician Services, LLC CurrentSince May 1, 2014 Accepting new patients
Providence Medical Center CurrentSince Feb 21, 1994 Accepting new patients
Providence Medical Center CurrentSince Feb 21, 1994 Accepting new patients
Mercy Medical Services Family Medicine PastSince Jan 1, 1990 Accepting new patients
Mercy Medical Services Family Medicine PastSince Jan 1, 1990 Accepting new patients
Lindahl Healthcare, Inc. Past Accepting new patients
Mercy Medical Services Family Medicine PastSince Jan 1, 1990 Accepting new patients

Locations

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

110 N 29th St
Ste 201
Norfolk, NE 68701
Phone (402) 844-8121

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

1200 Providence Rd
Wayne, NE 68787
Phone (402) 375-3800

615 E 14th St
Wayne, NE 68787
Phone (402) 375-2500

Interoperability endpoints

  • Direct secure messaging: mark.mccorkindale@nehiidirectmail.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1679528616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 328",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511020328",
            "telephone_number": "712-279-5830",
            "fax_number": "712-279-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E 14TH ST",
            "city": "WAYNE",
            "state": "NE",
            "postal_code": "687871152",
            "telephone_number": "402-375-2500",
            "fax_number": "402-375-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORKINDALE",
        "first_name": "MARK",
        "middle_name": "O.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "19231",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "29362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NE

Sources for this page

Verify at the official NPI Registry.