MEDICARE: JAMES ROBERT MCDERMOTT D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0100X	Occupational Health Chiropractor	AJ-007572-L	PA
2	111N00000X	Chiropractor	DC-007572-L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00115858	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MC348462	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1831160126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ROBERT MCDERMOTT D.C.

Provider Business Mailing Address
First Line	:	700 S POTOMAC ST
Second Line	:	SUITE 6
City	:	WAYNESBORO
State	:	PA
Zip	:	17268-2198
Country	:	US
Telephone Number	:	717-762-1773
Fax Number	:	717-762-8544

Provider Business Practice Location Address
First Line	:	569 PIERCE ST
Second Line	:
City	:	KINGSTON
State	:	PA
Zip	:	18704-5731
Country	:	US
Telephone Number	:	570-288-5800
Fax Number	:	570-288-5900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	09/11/2025

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