Individual provider Active NPI

Jessica Abigail McCoy

  • Acute Care Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1164288866
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
78110 Issued in NM
Practice address
504 Elm St NE
Albuquerque, NM 87102-2512
Phone
(505) 727-3170
NPI assigned
Feb 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11029919 FL
Gerontology Nurse Practitioner 363LG0600X APRN11029919 FL
Acute Care Nurse Practitioner 363LA2100X 78110 NM Primary

Addresses

Primary practice location

504 Elm St NE
Albuquerque, NM 87102-2512

Mailing address

2950 Cleveland Clinic Blvd
Weston, FL 33331-3625
Phone (954) 659-5000

Other practice location 1

8324 Calle Primera NW
Albuquerque, NM 87120-5386
Phone (484) 948-9398

Other practice location 2

2950 Cleveland Clinic Blvd
Weston, FL 33331-3625
Phone (954) 659-5000

Other identifiers 1

IdentifierTypeStateIssuer
78110OtherNMNM LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NM2 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
I20240607002133 FL Practitioner - Nurse Practitioner 2062954845 Reassigns benefits to 1 organization
I20250604003485 NM Practitioner - Nurse Practitioner 2062954845 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11029919FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Jun 1, 2025 Accepting new patients
Cleveland Clinic Florida a Nonprofit Corporation CurrentSince May 17, 2024 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

3100 Weston Rd
Weston, FL 33331
Phone (954) 689-5000

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

504 Elm St NE
Albuquerque, NM 87102
Phone (505) 724-2000

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 3

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": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1164288866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 CLEVELAND CLINIC BLVD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313625",
            "telephone_number": "954-659-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022512",
            "telephone_number": "505-727-3170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8324 Calle Primera NW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871205386",
            "country_code": "US",
            "telephone_number": "484-948-9398",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2950 Cleveland Clinic Blvd",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "FL",
            "postal_code": "333313625",
            "country_code": "US",
            "telephone_number": "954-659-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "JESSICA",
        "middle_name": "ABIGAIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11029919",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11029919",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "78110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM LICENSE",
            "identifier": "78110",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.