Heather Shealy McCormack

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

93187 Issued in SC

Practice address

5 Seibert Rd
Prosperity, SC 29127

Phone

(803) 944-2110

NPI assigned

Nov 26, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1679970255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SEIBERT RD",
            "city": "PROSPERITY",
            "state": "SC",
            "postal_code": "291277220",
            "telephone_number": "803-944-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SEIBERT RD",
            "city": "PROSPERITY",
            "state": "SC",
            "postal_code": "29127",
            "telephone_number": "803-944-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "HEATHER",
        "middle_name": "SHEALY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-26",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "93187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lovelace Family Medicine, PA
• Brittany Long Lovelace, PA - C
• Oscar F Lovelace Jr., MD
• Spencer Charles Lovelace, M.D.
• Low Country Outreach Services
• Jennifer McCullough, CCC-SLP
• Mid-Carolina Dental Care, Inc
• Laura Montgomery, PHARMD
• Carmen Monts
• Angela D Old, LISW-CP

• All providers in Prosperity, SC
• Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.