Individual provider Active NPI

William Robert McDermott, DC

  • Chiropractor
  • Havre de Grace, MD
National Provider Identifier
1952586166
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1540 Issued in MD
Practice address
319 S Union Ave
Havre de Grace, MD 21078-3201
Phone
(410) 939-1111
Fax
(410) 939-3552
NPI assigned
Jan 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1540 MD Primary

Addresses

Primary practice location

319 S Union Ave
Havre de Grace, MD 21078-3201

Mailing address

319 S Union Ave
Havre de Grace, MD 21078-3201
Phone (410) 939-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091013000535 MD Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 7416093026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Life Chiropractic College, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

933R Pulaski Hwy
Havre de Grace, MD 21078-2601
Phone (410) 939-1111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1540MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
McDermott Chiropractic Centre LTD Chiropractor CurrentSince May 26, 2009 Accepting new patients

Locations

319 S Union Ave
Hvre de Grace, MD 21078
Phone (410) 939-1111

933R Pulaski Hwy
Hvre de Grace, MD 21078
Phone (410) 939-1111

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.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1952586166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 S UNION AVE",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783201",
            "telephone_number": "410-939-1111",
            "fax_number": "410-939-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S UNION AVE",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783201",
            "telephone_number": "410-939-1111",
            "fax_number": "410-939-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-07",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "1540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

Verify at the official NPI Registry.