BARRY DODD MCCORMICK (NPI# 1952492076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952492076 |
| Entity Type | Individual |
| Full Name | BARRY DODD MCCORMICK |
| Credential | PA-C |
| Practice Address |
2204 Wilborn Ave South Boston VA 24592-1645 |
| Mailing Address |
6090 Philpott Rd South Boston VA 24592-6630 |
| Practice Telephone | 4345173123 |
| Mailing Telephone | 4345171114 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2011-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110002391 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2204 WILBORN AVE |
| City | SOUTH BOSTON |
| State | VA |
| Zip Code | 24592-1645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668842 | Halifax Regional Hospital, Inc. | General Acute Care Hospital | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2005-06-02 |
| 1871058008 | Angeline Marie Davis | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2019-02-01 |
| 1063931897 | Jon Michael Hughes | Nurse Practitioner | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-09-13 |
| 1265950646 | Mara Olivia Fiorio | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-09-06 |
| 1942745526 | Alisyn L. Metz | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-01-05 |
| 1255876835 | Andrew D. Metz | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-01-05 |
| 1942743398 | Melaku Akele | Physical Therapist | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-12-01 |
| 1740730316 | Emily Silsby | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-10-07 |
| 1023567153 | Mulbriar Emergency Physicians LLC | Physician Assistant | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-09-30 |
| 1205381621 | Banister River Emergency Physicians LLC | Physician Assistant | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966398 | Transformations Center for Health Wellness LLC | Counselor | 2170 Sandy Beach Road, South Boston, VA 24592 | 2019-11-12 |
| 1740830215 | Kirstyn Lokker | Occupational Therapist | 1 High School Circle, South Boston, South Boston, VA 24592 | 2019-09-17 |
| 1841764248 | Nicole Ivey | Occupational Therapy Assistant | 103 Rosehil Rd, South Boston, VA 24592 | 2019-01-18 |
| 1841700960 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 130 Aubreys Loop, South Boston, VA 24592 | 2017-10-03 |
| 1659828820 | Family Preservation Services, Inc | Community/Behavioral Health | 1 High School Circle, South Boston, VA 24592 | 2016-09-06 |
| 1316222821 | Family and Children Enrichment Services Inc. | Health Maintenance Organization | 220 Paradise Lane, South Boston, VA 24592 | 2011-10-15 |
| 1326365578 | Brinda Howard | Nurse's Aide | 104 Love Shop Park Rd Lot #25, South Boston, VA 24592 | 2010-04-28 |
| 1356513543 | Betts Medical Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 403 Factory Street, Suite B, South Boston, VA 24592 | 2008-03-27 |
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1437352945 | Behavioral Health Associates, Inc. | Non-emergency Medical Transport (VAN) | 515 Yancey Ave, South Boston, VA 24592 | 2007-06-11 |
| Find all providers in zip 24592 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659842557 | Blake Aaron Rogers | Physician Assistant | 2210 Wilborn Ave, South Boston, VA 24592-1630 | 2018-12-17 |
| 1548530827 | Nicholas Robert Hall | Physician Assistant | 2210 Wilborn Ave, South Boston, VA 24592-1630 | 2012-01-04 |
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|---|---|---|---|---|
| 1124638986 | Courtney Anne Kassner | Physician Assistant | 2706 Davis Ave, Alexandria, VA 22302-2817 | 2020-08-06 |
| 1295356145 | Nilofar Ariasaif | Physician Assistant | 15401 Bald Eagle Ln, Woodbridge, VA 22191-3782 | 2020-05-01 |
| 1396366555 | Sheelon Aghili | Physician Assistant | 5801 Hampton Forest Way, Fairfax, VA 22030-7254 | 2020-04-29 |
| 1679102347 | Mary Herrera | Physician Assistant | 6353 Center Dr Ste 204, Norfolk, VA 23502-0001 | 2020-04-05 |
| 1720614019 | Andrew James Meyers | Physician Assistant | 229 W Bute St Apt 207, Norfolk, VA 23510-1415 | 2020-03-18 |
| 1902432644 | Madison Alexis Cooper | Physician Assistant | 920 Battlefield Blvd S Ste 101, Chesapeake, VA 23322-4254 | 2020-03-13 |
| 1285296111 | Kimberly Stewart Hugo | Physician Assistant | 10932 Point Grey Road, Henrico, VA 23233-2429 | 2019-07-01 |
| 1558824698 | Jessica Leigh Pacuch | Physician Assistant | 2440 Raphine Rd, Raphine, VA 24472-2541 | 2019-04-06 |
| 1073074431 | Nicholas Alexander Jones | Physician Assistant | 924 Parley Pl, Chesapeake, VA 23323-4135 | 2019-03-28 |
| 1003371410 | Ryan Timothy Pyles | Physician Assistant | 25 Commerce Park Drive, Raphine, VA 24472 | 2019-02-11 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BOSTON |
| Zip Code | 24592 |
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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.