Active NPI
Brian J McCormack, MD
- Family Medicine Physician
- Reno, NV
National Provider Identifier
1932107471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4977
- Practice address
- 21 Locust St
Reno, NV 89502-1316 - Phone
- (775) 982-5000
- Fax
- (775) 982-3900
- NPI assigned
- Jul 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4977 | NV | Primary |
Addresses
Primary practice location
21 Locust St
Reno, NV 89502-1316
Mailing address
1155 Mill St # McM14
Reno, NV 89502-1576
Phone (775) 982-5262
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11041133 | Other | CAQH | |
| P00330270 | Other | NV | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4977 | NV | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Health Management Company | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Sparks, NV
- NPI 1861445892
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1932107471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 MILL ST # MCM14",
"city": "RENO",
"state": "NV",
"postal_code": "895021576",
"telephone_number": "775-982-5262",
"fax_number": "775-982-5496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 LOCUST ST",
"city": "RENO",
"state": "NV",
"postal_code": "895021316",
"telephone_number": "775-982-5000",
"fax_number": "775-982-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMACK",
"first_name": "BRIAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-08",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "4977",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11041133",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00330270",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.