Edward John McCormack Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 4994 Issued in FL

Practice address

7200 W Camino Real
Suite 101
Boca Raton, FL 33433-5511

Phone

(561) 789-2046

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

Yes

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 FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• F.I.T. PT, LLC

  • Clinic/Center
  • Boca Raton, FL
  • NPI 1508366550

  Physical Therapist

  Medicare reassignment NPD
• Physical Therapy in Your Home Inc

  • Physical Therapy Clinic/Center
  • Boca Raton, FL
  • NPI 1356353437
  NPD (past) Authorized official

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1922100700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 SW 7TH CT",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334866951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 W CAMINO REAL",
            "address_2": "SUITE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335511",
            "telephone_number": "561-789-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "EDWARD",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 4994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT04994",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naadira Faith McClain, D.O.
• Maria McClendon
• William W McClerkin, MD
• Jesse McClure, MD
• Krystal Marie McConnell
• Jill Marie McCormack, MOTR/L
• Mark B McCormick, MD
• Emily McCoy
• Judith Leanne McCoy, RN
• Amy McCratic

• Physical Therapist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.