MEDICARE: DR. JAMES MCCORMICK DPM

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	213ES0131X	Foot Surgery Podiatrist	DPM00281	RI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
14	164100001	OTHER	RI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	400540	OTHER		BLUE CHIP GROUP NUMBER
2	9146868001	OTHER		CIGNA GROUP NUMBER
3	400540	OTHER	RI	BLUE CHIP RI
4	PT SSN #	OTHER	RI	TRI CARE
5	0000031649	OTHER	RI	BCBC OF RI
6	1358850	OTHER	RI	AETNA HMO
7	204928511	OTHER	RI	UNITED HEALTH CARE
8	480020466	OTHER		GENERIC7
9	AA69500	OTHER	RI	HARVARD PILGRIM
10	1164100001	OTHER		GENERIC6
11	580173	OTHER		GENERIC3 GROUP NUMBER
12	583173	OTHER		GENERIC3
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	5807131	OTHER	RI	AETNA COMMERCIAL
16	0000007213	OTHER		GENERIC4 GROUP NUMBER
17	9146868001	OTHER		CIGNA
18	2944	OTHER		NEIGHBORHOOD HEALTH PLANS

General Provider Information

NPI Number	:	1972566644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MCCORMICK DPM

Provider Business Mailing Address
First Line	:	24 SALT POND RD
Second Line	:	UNIT E1
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4314
Country	:	US
Telephone Number	:	401-783-2424
Fax Number	:	401-789-2095

Provider Business Practice Location Address
First Line	:	24 SALT POND RD
Second Line	:	UNIT E1
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4314
Country	:	US
Telephone Number	:	401-783-2424
Fax Number	:	401-789-2095

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	08/29/2012

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