MR. BRIAN GERALD MCCORMICK (NPI# 1942781158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942781158 |
| Entity Type | Individual |
| Full Name | MR. BRIAN GERALD MCCORMICK |
| Credential | AGACNP-BC |
| Practice Address |
4600 College Blvd Ste 103 Overland Park KS 66211-1606 |
| Mailing Address |
901 E 104th St Kansas City MO 64131-4517 |
| Practice Telephone | 9132155008 |
| Practice Fax Number | 9132971202 |
| Mailing Telephone | 8165027117 |
| Mailing Fax Number | 8169329670 |
| Enumeration Date | 2018-08-25 |
| Last Update Date | 2020-03-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WE0003X |
Registered Nurse Specialization: Emergency |
2013031549 | MO | Nursing Service Providers |
| N | 163WE0003X |
Registered Nurse Specialization: Emergency |
14-133095-111 | KS | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2019015044 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
78736 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | RN LICENSE NUMBER | 2013031549 | 01 |
| KS | STATE DRIVER'S LICENSE | K02-98-0483 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4401 Wornall Rd, Kansas City, MO 641113241 | 8169325871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932738929 | Brian Patrick Mccormick | Student in an Organized Health Care Education/Training Program | 201 E University Pkwy Dept Of, Baltimore, MD 21218-2829 | 2020-04-02 |
| 1316570849 | Brian Keith Mccormick | Behavioral Analyst | 38 N Scott St, Carbondale, PA 18407-1888 | 2020-02-12 |
| 1396293874 | Brian Robert Mccormick | Social Worker | 1119 Raritan Ave, Highland Park, NJ 08904 | 2016-09-14 |
| 1861584419 | Brian K Mccormick | Nurse Practitioner | 298 Memorial Dr, Seneca, SC 29672-9443 | 2006-09-29 |
| 1790741122 | Brian C Mccormick | Family Medicine | 9 Manhattan Sq, Suite A, Hampton, VA 23666-5843 | 2006-04-25 |
| Street Address |
4600 COLLEGE BLVD STE 103 |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66211-1606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417177049 | Rhonda K Hornberger | Pharmacist | 4600 College Blvd Ste 103, Overland Park, KS 66211-1606 | 2007-04-26 |
| 1477115087 | Rogoi Lucy Mutuma | Nurse Practitioner | 4600 College Blvd Ste 103, Overland Park, KS 66211-1606 | 2019-07-03 |
| 1598220345 | Patricia Ngigi | Nurse Practitioner | 4600 College Blvd Ste 103, Overland Park, KS 66211-1606 | 2019-02-06 |
| 1841560877 | Diana M Richter | Nurse Practitioner | 4600 College Blvd Ste 103, Overland Park, KS 66211-1606 | 2012-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083211031 | Amanda Pierce | Nurse Practitioner | 8717 W 110th St Ste 270, Overland Park, KS 66210-2103 | 2020-10-02 |
| 1306462437 | Molly Myrl Milbourn | Nurse Practitioner | 12213 Briar Dr, Overland Park, KS 66209-1520 | 2020-06-24 |
| 1003445354 | Jaime Lee Kearney | Nurse Practitioner | 5716 W 89th St, Overland Park, KS 66207-2105 | 2020-04-07 |
| 1861026270 | William Dolan | Nurse Practitioner | 10800 Beverly St, Overland Park, KS 66211-1164 | 2020-02-24 |
| 1427611599 | Katharine M Moran | Nurse Practitioner | 5100 W 110th St Ste 200, Overland Park, KS 66211-1215 | 2019-04-15 |
| 1336604826 | Molly Price | Nurse Practitioner | 9720 W 87th St, Overland Park, KS 66212-4563 | 2019-02-08 |
| 1265902076 | Kayla Marie Watkins | Nurse Practitioner | 8625 College Blvd Ste 103, Overland Park, KS 66210-2192 | 2018-12-05 |
| 1750851911 | Danielle Traudt | Nurse Practitioner | 8756 W 151st St, Overland Park, KS 66221-8705 | 2018-11-30 |
| 1700308079 | Nisa Ngoc Dang Gregson | Nurse Practitioner | 6700 W 121st St Ste 300, Overland Park, KS 66209-2028 | 2017-07-08 |
| 1376991091 | Abbie Elizabeth Martin | Nurse Practitioner | 1220 W. 106th Street, Suite 230, Overland Park, KS 66215 | 2016-06-03 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66211 |
Please comment or provide details below to improve the information on MR. BRIAN GERALD MCCORMICK.
| 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.