MICHAEL R MCCORMICK (NPI# 1700880333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700880333 |
| Entity Type | Individual |
| Full Name | MICHAEL R MCCORMICK |
| Credential | PA |
| Practice Address |
3111 Gunderson Drive Onalaska WI 54650-8512 |
| Mailing Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 6087968630 |
| Mailing Telephone | 6087827300 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2015-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1178 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
9485 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42989500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962018176 | Michael Patrick Mccormick | Physician Assistant | 76 Scott Cir, Dedham, MA 02026-6423 | 2020-09-22 |
| 1356710636 | Michael Mccormick | Physical Therapist | 5141 E. I-20, Service Road North, Willow Park, TX 76087 | 2015-09-17 |
| 1225295074 | Michael Vincent Mccormick II | Counselor | 720 South B St, Bldg# M-1 M-2, San Mateo, CA 94401 | 2008-05-20 |
| 1255423059 | Michael D Mccormick | Dentist | 116 S Front St, Dardanelle, AR 72834 | 2006-09-29 |
| 1780796177 | Michael Sean Mccormick | Dentist | 33 Center St, East Aurora, NY 14052-2244 | 2006-08-31 |
| 1336161181 | Michael Thomas Mccormick | Podiatrist | 115 Shamrock Blvd, Venice, FL 34293-1630 | 2006-07-24 |
| 1548204597 | Michael E Mccormick | Family Medicine | 86 Palmetto Rd, Rayville, LA 71269-6415 | 2006-06-16 |
| 1245279710 | Michael Cooper Mccormick | Dentist | 2015 Wilmington Rd, New Castle, PA 16105-1928 | 2006-06-06 |
| 1992753586 | Michael S Mccormick | Social Worker | 1129 Fall River Cir, Longmont, CO 80504-8770 | 2006-05-05 |
| 1235103938 | Michael A Mccormick | Surgery | 107 Town Center Rd, King of Prussia, PA 19406-2330 | 2006-02-17 |
| Street Address |
3111 GUNDERSON DRIVE |
| City | ONALASKA |
| State | WI |
| Zip Code | 54650-8512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619979663 | Matthew R Runde | Ophthalmology | 3111 Gunderson Drive, Onalaska, WI 54650-8447 | 2005-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568824027 | Kyle Quillin | Student in an Organized Health Care Education/Training Program | 236 Kevin Ct, Onalaska, WI 54650 | 2016-03-24 |
| 1831577881 | Katelyn Nicole Patten | Counselor | 575 Lester Ave, Onalaska, WI 54650 | 2015-05-11 |
| 1619369758 | Amelia Vruble | Registered Nurse | 1047 Terrace Drive, Onalaska, WI 54650 | 2015-02-26 |
| 1699186528 | C. Nathan Vannatta | Physical Therapist | 3111 Gunersen Dr, Onalaska, WI 54650 | 2014-05-13 |
| 1770867640 | Claire Sweet | Pharmacist | 9400 Hwy 16, Target T-0620, Onalaska, WI 54650 | 2011-10-10 |
| 1306140439 | Jared I Darveaux | Internal Medicine | 311 Gundersen Dr, Onalaska, WI 54650 | 2011-01-04 |
| 1326299488 | Demetrios Spyridon Theodoropoulos | Allergy & Immunology | 2727 Midwest Drive, Onalaska, WI 54650 | 2008-10-08 |
| 1114190618 | Nancy Ellen Reithel | Physical Therapist | 610 Westwood Drive, Onalaska, WI 54650 | 2008-04-07 |
| 1902972896 | Maplewood Dental | Dentist | 1202 County Trunk Ph, Suite 300, Onalaska, WI 54650 | 2006-11-24 |
| 1245309327 | Benjamin John Breidenbach | Chiropractor | 1640 George St, Lacrosse, WI 54650 | 2006-11-06 |
| Find all providers in zip 54650 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821612045 | Cassidy Renee Thomas | Physician Assistant | 1111 Delafield St Ste 209, Waukesha, WI 53188-3403 | 2020-06-03 |
| 1982056768 | Luke Harbers | Physician Assistant | 6226 Bankers Rd Ste 11, Mount Pleasant, WI 53403-9799 | 2016-07-06 |
| 1093085664 | Abraham David Pacheco | Physician Assistant | 3246 S 35th St, Milwaukee, WI 53215-4156 | 2012-01-12 |
| 1346577954 | Darren Rosser | Physician Assistant | 2931 S 108th St, West Allis, WI 53227-3519 | 2009-11-03 |
| 1033359401 | Matthew S. Bay | Physician Assistant | 1818 N. Meade St Suite 240 West, Fox Valley Surgical Associates, Appleton, WI 54911-3496 | 2009-02-25 |
| 1265657068 | Surgical and Rehab Services Inc | Physician Assistant | E4051 Steven Way, Spring Green, WI 53588-9271 | 2007-04-16 |
| 1992844385 | Jill Ann Schumacher | Physician Assistant | 2265 90th St, Eau Claire, WI 54703-0181 | 2007-02-05 |
| 1609915073 | Brian Felix Robinson | Physician Assistant | S725 Turner Valley Rd, Mondovi, WI 54755-8331 | 2007-02-05 |
| 1124176383 | William Henry Price | Physician Assistant | 4819 5th Ave, Unit 2, Kenosha, WI 53140-2924 | 2007-01-06 |
| 1619032919 | Michael R Depew | Physician Assistant | 1650 S. 41st St., Lakeshore Orthopedics, Manitowoc, WI 54220 | 2006-12-27 |
| Find all providers with the same taxonomy | ||||
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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.