Active NPI
Katanga McCoy, DPM
- Podiatrist
- Macon, GA
National Provider Identifier
1104832484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- POD0001008
- Practice address
- 940 Pio Nono Ave
Macon, GA 31204-4059 - Phone
- (478) 328-6466
- Fax
- (478) 328-1338
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | POD0001008 | GA | Primary |
Addresses
Primary practice location
940 Pio Nono Ave
Macon, GA 31204-4059
Mailing address
105 Wexford Cir
Bonaire, GA 31005-4734
Phone (478) 328-6466
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| POD0001008 | GA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104832484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 WEXFORD CIR",
"city": "BONAIRE",
"state": "GA",
"postal_code": "310054734",
"telephone_number": "478-328-6466",
"fax_number": "478-328-1338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 PIO NONO AVE",
"city": "MACON",
"state": "GA",
"postal_code": "312044059",
"telephone_number": "478-328-6466",
"fax_number": "478-328-1338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "KATANGA",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "GA",
"license": "POD0001008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.