Active NPI
Douglas McCoy, CPNP
- Pediatric Nurse Practitioner
- Bridgeport, CT
National Provider Identifier
1083020051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 20141527
- Practice address
- 46 Albion St.
Bridgeport, CT 06605 - Phone
- (203) 330-6000
- NPI assigned
- Jul 10, 2014
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 20141527 | MA | Primary |
Addresses
Primary practice location
46 Albion St.
Bridgeport, CT 06605
Mailing address
46 Albion St.
Bridgeport, CT 06605
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)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20141527 | MA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404950400000",
"number": "1083020051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 ALBION ST.",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 ALBION ST.",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06605",
"telephone_number": "203-330-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "CPNP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-10",
"last_updated": "2014-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MA",
"license": "20141527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.