Active NPI
Andrew Sean McCormick, PT
- Physical Therapist
- Winston Salem, NC
National Provider Identifier
1760893044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P9310
- Practice address
- 190 Kimel Park Dr Ste 139
Winston Salem, NC 27103-6946 - Phone
- (336) 718-6931
- NPI assigned
- May 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P9310 | NC | Primary |
Addresses
Primary practice location
190 Kimel Park Dr Ste 139
Winston Salem, NC 27103-6946
Mailing address
PO Box 601791
Charlotte, NC 28260-1791
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P9310 | Other | NC | NC BOARD OF PT EXAMINERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672876800000",
"number": "1760893044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601791",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 KIMEL PARK DR STE 139",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036946",
"telephone_number": "336-718-6931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "ANDREW",
"middle_name": "SEAN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-08",
"last_updated": "2023-01-05",
"certification_date": "2023-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P9310",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC BOARD OF PT EXAMINERS",
"identifier": "P9310",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
- Patrick Joseph McConville, MD
- Crystal McCord, PTA
- McCorkle Laboratory Enterprise LLC
- Tenika Chique McCorkle, DNP, FNP-BC
- Michael Joseph McCormack Jr., M.D.
- Morgan Taylor McCoy, MD
- Saleema S McCoy, LCSWA
- Willie Ray McCoy III, LCSW-A
- Hayley Rebekah McCraw, LCMHCA
- Lindsey Elizabeth McCready, M.ED., BCBA, LBA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.