Michael Kelly McCormick, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R102090-8 Issued in MN

Practice address

701 Dellwood St S
Cambridge, MN 55008-1920

Phone

(763) 689-7700

Fax

(763) 689-7941

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100Reported as apm

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972684892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-4813",
            "fax_number": "612-262-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DELLWOOD ST S",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081920",
            "telephone_number": "763-689-7700",
            "fax_number": "763-689-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "MICHAEL",
        "middle_name": "KELLY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R102090-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767043500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Mathson, SLP
• Matthew J Peterson, DDS, PA (Cambridge Dental Center)
• Arthur Mayo III
• Lashona Vaquisha Mays
• Kristina Brittany McCaughtry, M.D.
• Sheila McDermott-Hiney
• Rusty James McDonald, P.A.
• Madison Lee McFarlen
• Emily McGonigle, LMFT
• Megan McGovern Narlock, LPCC, LADC

• Certified Registered Nurse Anesthetist in Cambridge, MN
• Providers in Cambridge, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.