NPIMap

Individual provider Active NPI

Susan Elizabeth McCoy, FNP

  • Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1205007309
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP116650 Issued in TX
Practice address
5904 Summerfield Dr
Texarkana, TX 75503-4306
Phone
(430) 200-4350
Fax
(866) 337-1615
NPI assigned
Mar 17, 2008
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP116650 TX Primary
Family Nurse Practitioner 363LF0000X 652379 TX

Addresses

Primary practice location

5904 Summerfield Dr
Texarkana, TX 75503-4306

Mailing address

5904 Summerfield Dr
Texarkana, TX 75503-4306
Phone (430) 200-4350

Other identifiers 1

IdentifierTypeStateIssuer
193546203MedicaidTX

Other names 1

  • Susan Elizabeth Leftwich Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080618000764 TX Practitioner - Nurse Practitioner 1759452741 Reassigns benefits to 4 organizations
I20240805003473 AR Practitioner - Nurse Practitioner 1759452741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Midsouth Transitions Arkansas PAGroup PAC ID 1153731005, 16 clinicians
Midsouth Transitions Medical GroupGroup PAC ID 8628322831, 17 clinicians

Practice addresses (Care Compare)

Texarkana, AR 71854
Phone (430) 200-4350

5904 Summerfield Dr
Texarkana, TX 75503-4306
Phone (430) 200-4350

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midsouth Transitions Arkansas PA Family CurrentSince Jul 12, 2024 Accepting new patients
Midsouth Wound Care of Arkansas PLLC Family CurrentSince Jun 3, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2017 Accepting new patients
NE Texas Interventional Medicine, PA CurrentSince Jan 17, 2020 Accepting new patients
C H Wilkinson Physician Network Nurse Practitioner CurrentSince Aug 25, 2014 Accepting new patients
C H Wilkinson Physician Network CurrentSince Aug 25, 2014 Accepting new patients
Midsouth Transitions Medical Group Family CurrentSince Sep 11, 2019 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2017 Accepting new patients

Locations

3030 North St
Ste 420
Beaumont, TX 77702
Phone (409) 835-2900

919 Hidden Rdg
Irving, TX 75038

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

1311 Gen Cvazos Blvd
Kingsville, TX 78363
Phone (361) 595-1661

301 W 18th St
Ste 101
Mt Pleasant, TX 75455
Phone (903) 563-5478

2400 Saint Michael Dr
Fl 2
Texarkana, TX 75503
Phone (903) 614-7600

2602 Saint Michael Dr
Ste 400
Texarkana, TX 75503
Phone (903) 614-5670

5002 Cowhorn Creek Rd
Texarkana, TX 75503
Phone (903) 614-3008

5904 Summerfield Dr
Texarkana, TX 75503
Phone (430) 200-4350

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18412/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations & group practices 8

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1205007309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 SUMMERFIELD DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034306",
            "telephone_number": "430-200-4350",
            "fax_number": "866-337-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 SUMMERFIELD DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034306",
            "telephone_number": "430-200-4350",
            "fax_number": "866-337-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP116650",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "652379",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193546203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "LEFTWICH",
            "middle_name": "ELIZABETH",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.