NPIMap

Individual provider Active NPI

William Andrew McCormick, M.D.

  • Family Medicine Physician
  • Bristol, TN
National Provider Identifier
1740411313
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD47090 Issued in TN
Practice address
240 Medical Park Blvd Ste 3000
Bristol, TN 37620-7352
Phone
(423) 990-2400
Fax
(423) 990-2405
NPI assigned
Jul 30, 2009
Last updated
Jul 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD47090 TN Primary

Addresses

Primary practice location

240 Medical Park Blvd Ste 3000
Bristol, TN 37620-7352

Mailing address

PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20110511000589 TN Practitioner - Family PracticePractitioner - Emergency Medicine 6800072687 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
East Tennessee State University Quillen College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians
Dominion Health and Fitness, IncGroup PAC ID 3274570908, 71 clinicians

Practice addresses (Care Compare)

105 W Stone Dr
Suite 1F
Kingsport, TN 37660-3256
Phone (423) 230-2420

4862 Dickenson Hwy
PO Box 1810
Clintwood, VA 24228-1810

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD47090TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC CurrentSince Apr 1, 2017 Accepting new patients
Medical Education Assistance Corporation Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
Holston Medical Group PC Family Medicine CurrentSince Feb 1, 2012 Accepting new patients
Wellmont Health System Past Accepting new patients
Page Memorial Hospital Inc. Past Accepting new patients

Locations

350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 323-6900

105 W Stone Dr
Ste 1F
Kingsport, TN 37660
Phone (423) 230-2420

2204 Pavilion Dr
Ste 200
Kingsport, TN 37660
Phone (423) 224-3900

Interoperability endpoints

  • Direct secure messaging: williammccormick@hmgpath.allscriptsdirect.net

Organizations & group practices 6

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 8

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": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1740411313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2066",
            "fax_number": "423-857-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MEDICAL PARK BLVD STE 3000",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207352",
            "telephone_number": "423-990-2400",
            "fax_number": "423-990-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "WILLIAM",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-30",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD47090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.