Individual provider Active NPI

Carter Jameson McCormack, M.D.

  • Surgery Physician
  • Clinton, SC
National Provider Identifier
1710970520
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33343 Issued in SC
Practice address
1012 Medical Ridge Rd
Clinton, SC 29325-4542
Phone
(864) 833-3852
Fax
(864) 938-0501
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 33343 SC Primary
Surgery Physician 208600000X 2024-00957 NC

Addresses

Primary practice location

1012 Medical Ridge Rd
Clinton, SC 29325-4542

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6303

Other identifiers 2

IdentifierTypeStateIssuer
3271200MedicaidNJ
333437MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110513000587 SC Practitioner - General Surgery 9133145105 Reassigns benefits to 4 organizations
I20251117001760 NC Practitioner - General Surgery 9133145105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

1901 S Hawthorne Rd
Suite 220
Winston Salem, NC 27103-3914
Phone (336) 718-6777

50 E Hospital St
Suite 4
Manning, SC 29102-3149
Phone (803) 435-2822

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-00957NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Health System CurrentSince Jul 1, 2013 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 1, 2013 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 1, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 1, 2013 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Nov 14, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Greenville Health System CurrentSince Jul 1, 2013 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 1, 2025 Accepting new patients
McLeod Physician Associates II Surgery CurrentSince Oct 22, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Greenville Health System Current Accepting new patients
McLeod Physician Associates II CurrentSince Oct 22, 2023 Accepting new patients
Galler & Feinberg Surgical Associates Surgery Past Accepting new patients
McLeod Physician Associates II Past Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

1710 Kernersville Medical Pkwy
Ste 220
Kernersville, NC 27284
Phone (336) 564-4035

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

211 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-1191

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

250 Charlois Blvd
Winston Salem, NC 27103
Phone (336) 718-1000

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

1901 S Hawthorne Rd
Ste 210
Winston Salem, NC 27103
Phone (336) 718-5000

1901 S Hawthorne Rd
Ste 220
Winston Salem, NC 27103
Phone (336) 718-6777

721 S Doctors Dr
Cheraw, SC 29520
Phone (843) 320-9086

1012 Medical Ridge Rd
Clinton, SC 29325
Phone (864) 399-9070

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

2 Office Park Ct
Ste 103
Columbia, SC 29223
Phone (256) 497-0032

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

506 E Cheves St
#202
Florence, SC 29506

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

50 E Hospital St
Ste 4
Manning, SC 29102
Phone (803) 435-2822

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: cmccormack1727325@direct.novanthealth.org
  • Direct secure messaging: cmccormack5710@direct.ghs.myhfn.org
  • Direct secure messaging: cmccormack86549@directmcleodehealth.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 2

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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1710970520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6303",
            "fax_number": "864-797-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 MEDICAL RIDGE RD",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293254542",
            "telephone_number": "864-833-3852",
            "fax_number": "864-938-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "CARTER",
        "middle_name": "JAMESON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "33343",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2024-00957",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3271200",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333437",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, SC

Sources for this page

Verify at the official NPI Registry.