Active NPI
Monty Paul McCoy
- In Home Supportive Care Agency
- Henderson, NV
National Provider Identifier
1043825854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 264 Mattino Way
Henderson, NV 89074-1434 - Phone
- (702) 806-7028
- Fax
- (443) 596-1281
- NPI assigned
- Sep 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
264 Mattino Way
Henderson, NV 89074-1434
Mailing address
264 Mattino Way
Henderson, NV 89074-1434
Phone (702) 806-7028
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568831147 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599609600000",
"number": "1043825854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "264 MATTINO WAY",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890741434",
"telephone_number": "702-806-7028",
"fax_number": "443-596-1281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 MATTINO WAY",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890741434",
"telephone_number": "702-806-7028",
"fax_number": "443-596-1281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "MONTY",
"middle_name": "PAUL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-09",
"last_updated": "2020-09-09",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1568831147",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.