Teresa Ann McCormack, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

784994 Issued in CA

Practice address

4443 30TH St Ste 205
San Diego, CA 92116-4291

Phone

(619) 312-1832

NPI assigned

Feb 4, 2019

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 names 1

• Teresa Ann McCormack Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Teresa McCormack Lactation Support LLC

  • Lactation Consultant (Registered Nurse)
  • San Diego, CA
  • NPI 1861950545
  NPD (past) Authorized official

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1790240885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9728 MARILLA DR UNIT 205",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920402853",
            "telephone_number": "858-216-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4443 30TH ST STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164291",
            "telephone_number": "619-312-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "credential": "RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "784994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "MCCORMACK",
            "middle_name": "ANN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meghan C McCool, RN, CCRN. MBA
• Karen Joyce McCord-Sullivan, PT
• Gregory Bradford McCord, MA, MDIV.
• Monica J. McCorkle, MS, RD, CDE
• McCormack Dental Imaging
• Alice Chrysanthemum McCormick
• George McCormick
• Jamey McCormick
• Sarah Kathleen McCormick, BSN, RN
• Danielle McCourt

• Lactation Consultant (Registered Nurse) in San Diego, CA
• Providers in San Diego, CA by specialty
• Lactation Consultant (Registered Nurse) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.