MS. KERIN A MCCORMACK (NPI# 1992034946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992034946 |
| Entity Type | Individual |
| Full Name | MS. KERIN A MCCORMACK |
| Credential | PA-C |
| Practice Address |
130 Baker Street Blackville SC 29817-2304 |
| Mailing Address |
86 Wren St Barnwell SC 29812-1529 |
| Practice Telephone | 8032841045 |
| Practice Fax Number | 8032843094 |
| Mailing Telephone | 8032595762 |
| Mailing Fax Number | 8032593250 |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2018-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 1484 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 1484DU | 05 |
| Street Address |
130 BAKER STREET |
| City | BLACKVILLE |
| State | SC |
| Zip Code | 29817-2304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235225608 | Low Country Health Care System, Inc. | Clinic/Center | 130 Baker Street, Blackville, SC 29817 | 2006-10-05 |
| 1194278879 | Kimberly Spires | Nurse Practitioner | 130 Baker Street, Blackville, SC 29817-2304 | 2016-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699808006 | Carolina Rural Practice Management, Inc. | Clinic/Center | 22 Gardener Rd, Box 247, Blackville, SC 29817-0247 | 2007-03-14 |
| 1215410667 | Low Country Health Care System | Clinic/Center | 19340 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2018-09-12 |
| 1821186461 | Blackville Health Investors | Pharmacy | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2006-10-10 |
| 1427393024 | Blackville Health Investors | Pharmacy | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2012-12-07 |
| 1932444676 | Blackville Health Investors Inc | Durable Medical Equipment & Medical Supplies | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2012-12-06 |
| 1659625846 | Rebecca Barr Copeland | Pharmacist | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2012-11-09 |
| 1639256605 | Daniels Pharmacy # 3 Inc | Durable Medical Equipment & Medical Supplies | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2006-11-01 |
| 1477505337 | Barnwell School District 19 | Local Education Agency (LEA) | 297 Pascallas St, Blackville, SC 29817-2355 | 2006-05-17 |
| 1720603202 | Amy Nicole Ellis | Nurse Practitioner | 130 Baker St N, Blackville, SC 29817-2426 | 2020-06-10 |
| 1578922746 | Shawnta Harrison | Case Manager/Care Coordinator | 337 Baker St N, Blackville, SC 29817-2431 | 2016-02-17 |
| Find all providers in zip 29817 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871757385 | Carolina Rural Practice Management, Inc. | Family Medicine | 22 Gardner Rd, Blackville, SC 29817-3126 | 2008-07-14 |
| 1467716787 | Sc Regional Health System LLC | Family Medicine | 22 Gardner Rd, Blackville, SC 29817-3126 | 2012-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495841 | Neuro Health Sc LLC | Family Medicine | 108 Commons Blvd Ste A, Piedmont, SC 29673-7766 | 2020-10-21 |
| 1811595499 | Laura Coolidge | Family Medicine | 1528 Seacroft Rd, Charleston, SC 29412-8113 | 2020-10-15 |
| 1154928570 | Lexington Health Inc | Family Medicine | 146 E Hospital Dr Ste 500, West Columbia, SC 29169-4842 | 2020-10-08 |
| 1477150340 | Meghan Hodapp | Family Medicine | 623 Awendaw Lakes Blvd, Awendaw, SC 29429-6407 | 2020-10-05 |
| 1033716253 | Proactive Md Tindall Spartanburg Health Center | Family Medicine | 2273 Hayne St., Spartanburg, SC 29301 | 2020-10-01 |
| 1851906267 | Avneet Nagra | Family Medicine | 162 Montauk Dr, Lexington, SC 29072-6776 | 2020-09-11 |
| 1134732753 | Ovp Health Care, Inc. | Family Medicine | 101 S Catawba St, Lancaster, SC 29720-2411 | 2020-08-24 |
| 1063024578 | Beaufort County Memorial Hospital | Family Medicine | Beaufort Memorial Preoperative Assessment Clinic, 989 Ribaut Road Suite 370, Beaufort, SC 29902 | 2020-08-18 |
| 1841801149 | Palmetto Primary Care Physicians, LLC | Family Medicine | 1200 Two Island Ct Unit E, Mt Pleasant, SC 29466-7418 | 2020-08-11 |
| 1922617950 | Fred E Hill | Family Medicine | 1033 Jervey Point Rd, Charleston, SC 29492-8372 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
| City | BLACKVILLE |
| Zip Code | 29817 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.