Individual provider Active NPI

Nathan McKoy

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1124379474
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R145014 Issued in MD
Practice address
401 E Eager St
Baltimore, MD 21202-4214
Phone
(410) 694-0061
NPI assigned
Sep 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R145014 MD Primary

Addresses

Primary practice location

401 E Eager St
Baltimore, MD 21202-4214

Mailing address

6426 English Oak CT
Linthicum, MD 21090-2724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170222001646 MD Practitioner - Nurse Practitioner 1658655444 Reassigns benefits to 1 organization
I20171220002373 DC Practitioner - Nurse Practitioner 1658655444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

1505 E Churchville Rd
Expresscare of Bel Air
Bel Air, MD 21014-4742
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715-4000
Phone (301) 383-0330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R145014MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Oct 17, 2017 Accepting new patients
MNR Industries, LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Dec 11, 2016 Accepting new patients
MNR Industries LLC CurrentSince Dec 11, 2016 Accepting new patients

Locations

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1124379474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6426 ENGLISH OAK CT",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E EAGER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024214",
            "telephone_number": "410-694-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKOY",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R145014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.