NPIMap

Organization Active NPI

Michael T. McCormick & Associates PA

  • Foot & Ankle Surgery Podiatrist
  • Venice, FL
National Provider Identifier
1710104583
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
MICHAEL T. MCCORMICK & ASSOCIATES PA
Practice address
115 Shamrock Blvd
Venice, FL 34293-1630
Phone
(941) 493-8666
Fax
(941) 497-5411
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Authorized official

Name
Roy Clint LairdNPI 1679673123
Title
Owner and DPM
Phone
(941) 493-8666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

115 Shamrock Blvd
Venice, FL 34293-1630

Mailing address

PO Box 825159
Philadelphia, PA 19182-5159
Phone (941) 493-8666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130711000446 FL Part B Supplier - Clinic/Group Practice 1759521933 Receives reassigned benefits from 6 practitioners
Practice locations: Venice, FL
O20140228000026 FL DME Supplier - Physician - Podiatry 1759521933 Practice locations: Venice, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Michael T McCormick Assoc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

17835 Murdock Cir
Unit B
Port Charlotte, FL 33948

115 Shamrock Blvd
Venice, FL 34293
Phone (941) 493-8666

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1710104583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825159",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825159",
            "telephone_number": "941-493-8666",
            "fax_number": "941-497-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SHAMROCK BLVD",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342931630",
            "telephone_number": "941-493-8666",
            "fax_number": "941-497-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL T. MCCORMICK & ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A",
        "authorized_official_last_name": "LAIRD",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "CLINT",
        "authorized_official_title_or_position": "OWNER AND DPM",
        "authorized_official_telephone_number": "941-493-8666"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.