Vicki Lynn McCormack, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-00907 Issued in NC

Practice address

407 Live Oak St
Suite 1
Beaufort, NC 28516-1944

Phone

(252) 728-2328

Fax

(252) 728-2628

NPI assigned

Oct 11, 2007

Last updated

Mar 9, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• DLP Western Carolina Physician Practices LLC

  • Internal Medicine Physician
  • Sylva, NC
  • NPI 1609281641
  Medicare reassignment
• DLP Western Carolina Physician Practices LLC

  dba Harris Pediatric Care

  • Rural Health Clinic/Center
  • Sylva, NC
  • NPI 1316718497
  NPD
• DLP Western Carolina Physician Practices LLC

  • Diagnostic Radiology Physician
  • Clyde, NC
  • NPI 1932925062
  NPD
• H Curtiss Merrick MD PA

  • Internal Medicine Physician
  • Morehead City, NC
  • NPI 1306120357
  NPD (past)
• Homer Curtiss Merrick III MD Dba H Curtiss Merrick MD

  • Specialist
  • Morehead City, NC
  • NPI 1386690378
  NPD (past)

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1780872028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 LIVE OAK ST",
            "address_2": "SUITE 1",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161944",
            "telephone_number": "252-728-2328",
            "fax_number": "252-728-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 LIVE OAK ST",
            "address_2": "SUITE 1",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161944",
            "telephone_number": "252-728-2328",
            "fax_number": "252-728-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "VICKI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "2770846B",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Patterson Swain D D S P a
• Lookout Pharmacy LLC
• Karen S Manspeaker
• Marjorie S Holland
• Winifred G McCarthy, REGISTERED NURSE
• Kayla McCutcheon
• Medical Park Pharmacy East, Inc (Medical Park Pharmacy East)
• Medical Park Pharmacy East, Inc. (Medical Park Pharmacy East)
• Helen Diane Meelheim, F.N.P.
• Maureen Gurney Migliore, MS, LPA

• Physician Assistant in Beaufort, NC
• Providers in Beaufort, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.