Edwin W. McCammack, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085-000055 Issued in IL

Practice address

101 W University Ave
Champaign, IL 61820-3909

Phone

(217) 366-1243

Fax

(217) 366-6106

NPI assigned

Aug 2, 2006

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1790792562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-8107",
            "fax_number": "217-366-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1243",
            "fax_number": "217-366-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAMMACK",
        "first_name": "EDWIN",
        "middle_name": "W.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-000055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00328875",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "434110",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaineez Maynor
• Phoebe Mueni Mbuvi, PA-C
• McCabe Chiropractic P.C.
• Emily McCabe, CHIROPRACTOR
• William John McCabe Jr., D.M.D.
• Hillary Rose McCann, APRN
• Colin Garrido McCarthy, PT, DPT
• James McCartney
• Anthony McCarty, RBT
• Peppertanner McClendon

• Medical Physician Assistant in Champaign, IL
• Providers in Champaign, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.