Kimberly McCoy, WHCNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

577946 Issued in TX

Practice address

115 Medical Cir Ste 103
Athens, TX 75751-9004

Phone

(903) 677-8453

Fax

(903) 677-8454

NPI assigned

Jun 16, 2005

Last updated

Feb 6, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Mark L Eldore MD PLLC

  dba Athens Women's and Children's Center

  • Obstetrics & Gynecology Physician
  • Athens, TX
  • NPI 1831107028

  Women's Health

  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1154326171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MEDICAL CIR STE 103",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519004",
            "telephone_number": "903-677-8453",
            "fax_number": "903-677-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MEDICAL CIR STE 103",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519004",
            "telephone_number": "903-677-8453",
            "fax_number": "903-677-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "WHCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "577946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178426602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S2732",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Martin, PHARMD
• Bonny McBride, LCSW
• Brenda Joy McBride, LCSW
• William A McBride, PHD
• Francine F McCain, M.D.
• Julie Kay McIntyre, LPC
• Tammy Renee McKibbin, LPC-A
• Nicholas Adam Medel, DDS
• Donald Joaseph Meyers, RPH
• MHP Partnership, LTD (Oak Wood Place Assisted Living)

• Women's Health Nurse Practitioner in Athens, TX
• Providers in Athens, TX by specialty
• Women's Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.