MATTHEW C MCCORMACK (NPI# 1598810145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598810145 |
| Entity Type | Individual |
| Full Name | MATTHEW C MCCORMACK |
| Credential | M.D. |
| Practice Address |
5560 Kietzke Ln. Bldg. A Reno NV 89511 |
| Practice Telephone | 7753227811 |
| Practice Fax Number | 7753221431 |
| Mailing Telephone | 7753227811 |
| Mailing Fax Number | 7753221431 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2018-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | A81129 | CA | Allopathic & Osteopathic Physicians |
| Y | 208800000X | Urology | 12111 | NV | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 699 Sierra Rose Dr Ste A, Reno, NV 895112069 | 7753227811 | 7753221431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972995413 | Matthew Thomas Mccormack | Chiropractor | 130 Descanso Dr, #152, San Jose, CA 95134-1890 | 2015-02-20 |
| Street Address |
5560 KIETZKE LN. BLDG. A |
| City | RENO |
| State | NV |
| Zip Code | 89511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841257235 | Jonathan S Garey-sage | Urology | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2006-04-28 |
| 1043731771 | Derek Glazier | Physician Assistant | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2017-07-03 |
| 1194014688 | Remy William Lamberts | Urology | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2011-04-05 |
| 1972765428 | Roland Roderick Goode | Urology | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2008-06-26 |
| 1700067303 | Cheryl Jean Finn | Nurse Practitioner | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2007-11-25 |
| 1194915835 | Timothy James Redden | Urology | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2007-07-30 |
| 1215130802 | Jeremy Lee Reichert | Physician Assistant | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2007-06-09 |
| 1588621056 | David E Hald | Urology | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2006-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407474695 | Katherine Lynn Mauldin | Physician Assistant | Redfield Campus Nell J. Redfield Bldg. A Suite 104, 18600 Wedge Parkway, Reno, NV 89511 | 2020-07-14 |
| 1902428915 | Roxann Jeanette Richardson | Student in an Organized Health Care Education/Training Program | Unr Redfield Campus Nell J. Redfield Bldg. A, Suite 104 18600 Wedge Parkway, Reno, NV 89511 | 2020-05-13 |
| 1487286654 | Noelle Marie Davis-marinaccio | Nurse Practitioner | 5570 Longley Lane, Reno, NV 89511 | 2020-02-06 |
| 1265092662 | Elysia Jones | Student in an Organized Health Care Education/Training Program | 18600 Wedge Parkway, Nell J. Redfield Building A, Suite 104, Reno, NV 89511 | 2019-06-18 |
| 1023583622 | Vera Whole Health, Wa PC | Clinic/Center | 699 Sierra Rose Drive, Reno, NV 89511 | 2018-10-10 |
| 1841786027 | Christina Willett | Speech-Language Pathologist | 14680 S. Quiet Meadow Drive, Reno, NV 89511 | 2018-07-10 |
| 1235630864 | High Sierra Psychiatry, LLC | Clinic/Center | Reno Behavioral Healthcare Hospital, 6940 Sierra Center Parkway, Reno, NV 89511 | 2018-02-28 |
| 1154839637 | Jacob Blake, Md Ltd. | Anesthesiology | 5590 Kietzke Lane, Reno, NV 89511 | 2018-01-18 |
| 1548776024 | Jennifer L. Shane O.d., Ltd | Optometrist | 5385 Reno Corporate Drive #100, Reno, NV 89511 | 2017-12-20 |
| 1619488525 | Reno Behavioral Healthcare Hospital, LLC | Psychiatric Hospital | 6940 Sierra Center Parkway, Reno, NV 89511 | 2017-10-18 |
| Find all providers in zip 89511 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013008135 | Angelo W Kanellos | Urology | 10745 Double R Blvd, Reno, NV 89521-8979 | 2006-09-27 |
| 1336259183 | Nevada Urology Associates | Urology | 699 Sierra Rose Dr Ste A, Reno, NV 89511-2069 | 2006-08-30 |
| 1770540064 | Joseph B Drew | Urology | 5560 Kietzke Ln, Bldg A, Reno, NV 89511-3019 | 2006-04-28 |
| 1437116704 | Christine N Lajeunesse | Urology | 1490 Stardust St, Reno, NV 89503-4238 | 2006-04-28 |
| 1518924943 | Steven L Moss | Urology | 1500 E Second St, Suite 300, Reno, NV 89502-1198 | 2006-04-28 |
| 1841257235 | Jonathan S Garey-sage | Urology | 5560 Kietzke Ln., Bldg. A, Reno, NV 89511 | 2006-04-28 |
| 1477510865 | Thomas W Brady | Urology | 1500 E Second St., Suite 300, Reno, NV 89502-1198 | 2006-04-28 |
| 1669439048 | John G Scott | Urology | 5560 Kietzke Ln Bldg A, Reno, NV 89511-3019 | 2006-04-28 |
| 1437711330 | Lexi Sara Jacobson | Urology | 10745 Double R Blvd, Reno, NV 89521-8979 | 2019-07-01 |
| 1821564360 | Jamie Peatrowsky | Urology | 5560 Kietzke Ln, Bldg A, Reno, NV 89511 | 2018-10-23 |
| Find all providers in RENO | ||||
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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.