Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Russell McCormick, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1568693133

Mary Russell McCormick, MD is a Family Practice in Johnson City, Tennessee. Graduated from East Tennessee State University Quillen College of Medicine in 2009, 17 years ago. Practices with Holston Medical Group PC, a 242-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
17
Trained at
East Tennessee State University Quillen College of Medicine
Licensed in
TN
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3019 Peoples St # CONDO300
Johnson City, TN 37604-1977
Phone: (423) 461-2100
Fax: (423) 461-2199
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 105 W Stone Dr Ste 3a, Kingsport, TN 37660-3365 — (423) 392-6200

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD48521 (TN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1568693133
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 30, 2009
Last updated in NPPESMarch 30, 2021
Certification dateMarch 30, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolEAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduated 2009 (17 years in practice)
Group practice Holston Medical Group Pc — 242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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