Individual provider Active NPI

Paul Wayne Cormier, N.P.

  • Family Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1922423698
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
653848 Issued in TX
Practice address
2830 Calder St
Beaumont, TX 77702-1809
Phone
(409) 892-7171
NPI assigned
Mar 4, 2014
Last updated
Mar 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 653848 TX Primary

Addresses

Primary practice location

2830 Calder St
Beaumont, TX 77702-1809

Mailing address

2830 Calder St
Beaumont, TX 77702-1809
Phone (409) 892-7171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20140602001939 TX Practitioner - Nurse Practitioner 2264655745 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid County Urgent Care, PLLCGroup PAC ID 9739339185, 4 clinicians

Practice addresses (Care Compare)

1908 Hwy 365
Nederland, TX 77627-5503
Phone (409) 729-1900

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
653848TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Texas PLLC CurrentSince Feb 15, 2018 Accepting new patients
Mid County Urgent Care, PLLC CurrentSince Sep 13, 2018 Accepting new patients
Acorn Medical Home Past Accepting new patients

Locations

2830 Calder St
Beaumont, TX 77702
Phone (409) 899-7000

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

1908 Highway 365
Nederland, TX 77627
Phone (409) 729-1900

3600 Gates Blvd
Port Arthur, TX 77642
Phone (409) 985-7431

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1922423698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 CALDER ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021809",
            "telephone_number": "409-892-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 CALDER ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021809",
            "telephone_number": "409-892-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORMIER",
        "first_name": "PAUL",
        "middle_name": "WAYNE",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "653848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.