Individual provider Active NPI

Marcia Lynn McCoy, PH.D.

  • Psychologist
  • El Dorado, KS
National Provider Identifier
1093802019
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
957 Issued in KS
Practice address
100 S. Main Street
Suite 205
El Dorado, KS 67042-0606
Phone
(316) 322-9500
Fax
(316) 322-9500
NPI assigned
Oct 10, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 957 KS Primary

Addresses

Primary practice location

100 S. Main Street
Suite 205
El Dorado, KS 67042-0606

Mailing address

PO Box 606
El Dorado, KS 67042-0606
Phone (316) 322-9500

Other identifiers 4

IdentifierTypeStateIssuer
4716OtherKSPREFERRED HEALTH SYSTEMS
118202OtherKSBCBS GROUP NUMBER
481246499 66502 A001OtherKSTRIWEST PROVIDER NUMBER
119741OtherKSBCBS INDIVIDUAL PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000037 KS Practitioner - Clinical Psychologist 8820194376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 S Main
205 PO Box 606
El Dorado, KS 67042-0606

100 S Main St
Suite 205
El Dorado, KS 67042-3402
Phone (316) 322-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
957KSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Psychological Services, PA Psychologist CurrentSince Jul 1, 2001 Accepting new patients
Richard & Donna Burnett PastSince May 1, 1995 Accepting new patients

Locations

100 S Main St
Ste 205
El Dorado, KS 67042
Phone (316) 322-9500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1093802019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 606",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670420606",
            "telephone_number": "316-322-9500",
            "fax_number": "316-322-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S. MAIN STREET",
            "address_2": "SUITE 205",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670420606",
            "telephone_number": "316-322-9500",
            "fax_number": "316-322-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "MARCIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH SYSTEMS",
            "identifier": "4716",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "118202",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST PROVIDER NUMBER",
            "identifier": "481246499 66502 A001",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PROVIDER",
            "identifier": "119741",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, KS

Sources for this page

Verify at the official NPI Registry.