CHARLES OWEN MCCORMICK III (NPI# 1700879830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700879830 |
| Entity Type | Individual |
| Full Name | CHARLES OWEN MCCORMICK III |
| Credential | M.D. |
| Practice Address |
30 N Emerson Ave Greenwood IN 46143-8895 |
| Practice Telephone | 3178813937 |
| Practice Fax Number | 3178874008 |
| Mailing Telephone | 3178813937 |
| Mailing Fax Number | 3178874008 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2010-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 01026314A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100154690 | 05 | |
| IN | BCBS | 000000214798 | 01 |
| IN | COLE VISION | 154727 | 01 |
| IN | UNITED MINE WORKERS | 352129520 | 01 |
| IN | MPLAN | 000000011606 | 01 |
| IN | RAILROAD MEDICARE | 180044022 | 01 |
| IN | SENIOR SMART CHOICE | 000000011606 | 01 |
| IN | AETNA | AETNA | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851328991 | Charles Robert Mccormick | Pediatrics | 1240 W Robinhood Dr, Suite G, Stockton, CA 95207-5507 | 2006-06-26 |
| 1710462395 | Charles David Mccormick | Nurse Practitioner | 399 Diederich Blvd, Ashland, KY 41101-7007 | 2018-09-28 |
| 1215195342 | Charles Patrick Mccormick | Psychiatry & Neurology | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2008-05-27 |
| 1104957505 | Charles Robert Mccormick Jr. | Dentist | 100 S Main St, Springboro, OH 45066 | 2007-03-08 |
| 1164482832 | Charles Calvin Mccormick | Family Medicine | 1201 S Miller St, Wenatchee, WA 98801 | 2006-03-25 |
| Street Address |
30 N EMERSON AVE |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46143-8895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730171208 | William Forrest Keeling | Ophthalmology | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2005-08-19 |
| 1588114912 | Lesley Adibe M.d.,p.c. | Anesthesiology | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2016-10-10 |
| 1770611055 | Wilfrido M. Tinio Md | Anesthesiology | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2007-03-01 |
| 1871675173 | Leonardo A. Patron, Md, Inc. | Anesthesiology | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2006-10-19 |
| 1245266600 | Carissa M Barina | Ophthalmology | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2006-06-25 |
| 1487635819 | Leonardo A Patron | Anesthesiology | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2005-11-11 |
| 1669453163 | Wilfrido Tinio | Anesthesiology | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2005-11-10 |
| 1013905827 | Indiana Eye Clinic, LLC | Ophthalmology | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2005-10-06 |
| 1346233905 | Ambulatory Surgery Center At Indiana Eye Clinic LLC | Clinic/Center | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2005-08-29 |
| 1578556148 | Glasshouse Optical, Inc | Eyewear Supplier (Equipment, not the service) | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2005-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395299 | Tiffany Smirat | Pharmacist | 882 S Sr 135, Greenwood, IN 46143 | 2020-10-27 |
| 1083250138 | Benajmin Thomas Nyboer | Pharmacist | 5961 North State Road 135, Kroger Pharmacy, Greenwood, IN 46143 | 2019-11-25 |
| 1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
| 1194282525 | Homebased Mental Health Service | Case Management | 2244 Blossom Dr, Greenwood, IN 46143 | 2019-02-21 |
| 1710478078 | Anne E Packard | Pharmacist | 333 E County Line Rd # 101, Greenwood, IN 46143 | 2018-05-22 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1891246633 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 5961 N Sr 135, Greenwood, IN 46143 | 2016-10-17 |
| 1477919637 | Ourhealth Physicians Group, LLC | Clinic/Center | 1273 N Emerson Ave Ste H, Greenwood, IN 46143 | 2016-01-04 |
| 1003212655 | American Health Network of Indiana, LLC | Non-Pharmacy Dispensing Site | 2355 Endress Place St A, Healthy Measures Wellness Clinic, Greenwood, IN 46143 | 2014-11-10 |
| 1265831366 | Katie D'agosto | Counselor | 3000 S State Road 135 Ste 230, Greenwood, IN 46143 | 2014-08-14 |
| Find all providers in zip 46143 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396766291 | Paul I. Kosko | Ophthalmology | 1503 Strong Ave, Greenwood, MS 38930-4036 | 2006-07-23 |
| 1730171208 | William Forrest Keeling | Ophthalmology | 30 N Emerson Ave, Greenwood, IN 46143-8895 | 2005-08-19 |
| 1134128630 | Jerry E Galloway | Ophthalmology | 202 Overland Dr, Greenwood, SC 29646-4069 | 2005-07-18 |
| 1528066644 | Coleman Eye Center, Pllc | Ophthalmology | 2005 Highway 82 W, Greenwood, MS 38930-2720 | 2005-07-12 |
| 1730186099 | Marvin G. Burdette Jr. | Ophthalmology | 665 West Alexander Road, Greenwood, SC 29646 | 2005-07-01 |
| 1548263643 | John Devore Compton Jr. | Ophthalmology | 210 Wells Ave, Greenwood, SC 29646-3843 | 2005-05-23 |
| 1205204377 | Southside Center for Sight | Ophthalmology | 701 E County Line Road, Suite 202, Greenwood, IN 46143-1071 | 2015-09-08 |
| 1003013970 | Jennifer Lynn Hershberger | Ophthalmology | 665 West Alexander Road, Greenwood, SC 29646 | 2007-07-02 |
| 1285742163 | Christopher Bauer Pesavento | Ophthalmology | 701 E County Line Rd, Suite 202, Greenwood, IN 46143-1072 | 2006-08-29 |
| 1285661454 | Galloway Regional Eye Center Pa | Ophthalmology | 202 Overland Dr, Greenwood, SC 29646-4069 | 2006-06-26 |
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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.