Gary L McCorkle, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17910 Issued in CA

Practice address

3431 Broadway St
A8
American Canyon, CA 94503-1228

Phone

(707) 731-1108

Fax

(707) 652-2679

NPI assigned

Mar 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Newmd Urgent Care Center, Inc.

  • Urgent Care Clinic/Center
  • American Canyon, CA
  • NPI 1184065823
  NPD (past)
• Premier Emergency Physicians of Idaho Medical Group

  • Emergency Medicine Physician
  • Nampa, ID
  • NPI 1942259965
  NPD (past)
• Treasure Valley Emergency Physicians

  • Emergency Medicine Physician
  • Nampa, ID
  • NPI 1053360065
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1891810099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 BROADWAY ST",
            "address_2": "A8",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945031228",
            "telephone_number": "707-731-1108",
            "fax_number": "707-652-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 BROADWAY ST",
            "address_2": "A8",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945031228",
            "telephone_number": "707-731-1108",
            "fax_number": "707-652-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORKLE",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17910CA",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Martinez
• Sergio Sanchez Martinez
• Elizabeth Barg Martorana, PA-C
• Derek McClure, BOCPO
• Thomas Michael McCombs, DO
• Karen McCrary, BCBA
• McGrew Behavior Intervention Services, Inc.
• McGrew Behavioral Health Services, Inc.
• Deborah M McGrew, MFT, BCBA-D
• Erin Kathleen McGuire, BCBA

• Physician Assistant in American Canyon, CA
• Providers in American Canyon, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.