Individual provider Active NPI

Phillip A Coy, D.O.

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1215922216
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1216 Issued in TN
Practice address
619 Skyline Dr
Jackson, TN 38301-3903
Phone
(731) 422-0213
Fax
(731) 882-5052
NPI assigned
Sep 15, 2005
Last updated
Dec 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1216 TN Primary

Addresses

Primary practice location

619 Skyline Dr
Jackson, TN 38301-3903

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 423-8697

Other identifiers 1

IdentifierTypeStateIssuer
3305276MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080722000332 TN Practitioner - Family Practice 6204835689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians

Practice addresses (Care Compare)

101 Garrett Dr
Medina, TN 38355-9641
Phone (731) 422-0355

145 Innovation Dr
Jackson, TN 38305-3019
Phone (731) 422-0213

149 Commons Dr
Martin, TN 38237-3882
Phone (731) 422-0213

1893 S Highland Ave
Jackson, TN 38301-7799
Phone (731) 423-5585

22 2ND Ave
Huntingdon, TN 38344-3806
Phone (731) 422-0213

2859 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

2863 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

3568 Chere Carol Rd
Humboldt, TN 38343-3639
Phone (731) 664-1375

4039 S Highland St
Milan, TN 38358-3483
Phone (731) 686-8995

619 Skyline Dr
Jackson, TN 38301-3903
Phone (731) 422-0213

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1216TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA Family Medicine CurrentSince Aug 9, 1999 Accepting new patients
Jackson Clinic PA CurrentSince Aug 9, 1999 Accepting new patients

Locations

622 W Market St
Bolivar, TN 38008
Phone (731) 658-2885

2859 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8360

2863 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8300

619 Skyline Dr
Jackson, TN 38301
Phone (731) 424-3682

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

4039 Highland St
Milan, TN 38358
Phone (731) 660-8755

Interoperability endpoints

  • Direct secure messaging: phillipcoy@jcpa.allscriptsdirect.net

Organizations & group practices 2

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 7

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1215922216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-423-8697",
            "fax_number": "731-423-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013903",
            "telephone_number": "731-422-0213",
            "fax_number": "731-882-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COY",
        "first_name": "PHILLIP",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3305276",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.