Individual provider Active NPI

Abraham Lincoln McCoy, PA-C

  • Physician Assistant
  • Durham, NC
National Provider Identifier
1205812922
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102095 Issued in NC
Practice address
7810 NC-751
Suite 150
Durham, NC 27713-6924
Phone
(919) 220-5255
NPI assigned
Dec 15, 2005
Last updated
Jul 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 102095 NC Primary

Addresses

Primary practice location

7810 NC-751
Suite 150
Durham, NC 27713-6924

Mailing address

PO Box 5105
Belfast, ME 04915-5100
Phone (919) 220-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100507000342 NC Practitioner - Physician Assistant 4486782737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
102095NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physician Assistant CurrentSince Dec 2, 2002 Accepting new patients
Emergeortho PA CurrentSince Dec 2, 2002 Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

1111 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 584-4322

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

7810 NC 751 Hwy
Durham, NC 27713
Phone (919) 544-7270

7810 NC 751 Hwy
Ste 150
Durham, NC 27713
Phone (919) 544-7270

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1205812922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7810 NC-751",
            "address_2": "SUITE 150",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136924",
            "telephone_number": "919-220-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "ABRAHAM",
        "middle_name": "LINCOLN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2022-07-11",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.