Individual provider Active NPI

Richard McCormick, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1760060826
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MCCO-434QAM Issued in NC
Practice address
1000 Blythe Blvd FL 4
Charlotte, NC 28203-5812
Phone
(704) 381-6800
Fax
(704) 381-6841
NPI assigned
Mar 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MCCO-434QAM NC Primary

Addresses

Primary practice location

1000 Blythe Blvd FL 4
Charlotte, NC 28203-5812

Mailing address

3500 Wilder LN
Orlando, FL 32804-3532
Phone (407) 694-2017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241114000101 NC Practitioner - Pediatric Medicine 3678976016 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MCCO-434QAMNCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Pediatrics Current Accepting new patients
Carolinas Medical Center Pediatrics CurrentSince Jul 1, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Jul 1, 2024 Accepting new patients

Locations

1000 Blythe Blvd
Fl 4
Charlotte, NC 28203
Phone (704) 355-8188

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1760060826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 WILDER LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328043532",
            "telephone_number": "407-694-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD FL 4",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-381-6800",
            "fax_number": "704-381-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "MCCO-434QAM",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.