Kerin A McCormack, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1484 Issued in SC

Practice address

209 Abbeville Ave NW
Aiken, SC 29801-3923

Phone

(803) 306-1433

Fax

(803) 632-1209

NPI assigned

Dec 21, 2009

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Low Country Health Care System, Inc

  • Federally Qualified Health Center (FQHC)
  • Bamberg, SC
  • NPI 1306378310
  Medicare reassignment NPD
• Low Country Health Care System, Inc

  • Federally Qualified Health Center (FQHC)
  • Barnwell, SC
  • NPI 1578659942
  Medicare reassignment NPD
• Low Country Health Care System, Inc

  • Federally Qualified Health Center (FQHC)
  • Barnwell, SC
  • NPI 1780112912
  Medicare reassignment NPD
• Low Country Health Care System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Blackville, SC
  • NPI 1235225608
  NPD

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1992034946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 WREN ST",
            "city": "BARNWELL",
            "state": "SC",
            "postal_code": "298121529",
            "telephone_number": "803-259-5762",
            "fax_number": "803-259-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 ABBEVILLE AVE NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013923",
            "telephone_number": "803-306-1433",
            "fax_number": "803-632-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "KERIN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-21",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "1484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "AA4884",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "1484",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1338PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Mazzell, RN
• Trinity Stephanie McCarley, OTR/L
• Deborah Lynn McCarson, LPN
• Brooke Ekalla McCarthy, MS
• Taylor Elizabeth McClure, PHARMD
• Ashley McCorry, DPT, OCS
• Jeremy R McCoy, LMSW
• Thomas McCullough
• Ariel McCurry
• William McCutchen III, D.O.

• Family Medicine Physician in Aiken, SC
• Providers in Aiken, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.