Individual provider Active NPI

Beth A McCoy

  • Nurse Practitioner
  • Bardstown, KY
National Provider Identifier
1285089375
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3010021 Issued in KY
Practice address
141 Parkway Dr
Bardstown, KY 40004-3220
Phone
(502) 348-4757
Fax
(502) 348-4755
NPI assigned
Apr 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 3010021 KY Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3010021 KY

Addresses

Primary practice location

141 Parkway Dr
Bardstown, KY 40004-3220

Mailing address

947 Shelbyville Rd
Taylorsville, KY 40071-9730
Phone (502) 876-0837

Other practice location 1

1000 E John Rowan Blvd Ste 107
Bardstown, KY 40004-2060
Phone (502) 331-6002

Other identifiers 1

IdentifierTypeStateIssuer
7100400070MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20160721001782 KY Practitioner - Nurse Practitioner 5193018646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McCoy Primary Care LLCGroup PAC ID 3779810619, 2 clinicians

Practice addresses (Care Compare)

1000 E John Rowan Blvd
Suite 107
Bardstown, KY 40004-2060
Phone (502) 331-6002

141 Pkwy Dr
Bardstown, KY 40004-3220
Phone (502) 348-4757

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3010021KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Embrace Hope Recovery Center Psychiatric/Mental Health CurrentSince Mar 13, 2024 Accepting new patients
McCoy Primary Care LLC CurrentSince May 22, 2019 Accepting new patients
Pearl Medical Practice PLLC PastSince Jan 31, 2021 Accepting new patients

Locations

1000 E John Rowan Blvd
Ste 107
Bardstown, KY 40004
Phone (502) 331-6002

141 Parkway Dr
Bardstown, KY 40004
Phone (502) 348-4757

129 Parkway Dr
Bardstown, KY 40004
Phone (502) 233-9696

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.

Hospital & facility affiliations 3

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1285089375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 SHELBYVILLE RD",
            "city": "TAYLORSVILLE",
            "state": "KY",
            "postal_code": "400719730",
            "telephone_number": "502-876-0837",
            "fax_number": "502-348-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 PARKWAY DR",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400043220",
            "telephone_number": "502-348-4757",
            "fax_number": "502-348-4755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E John Rowan Blvd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Bardstown",
            "state": "KY",
            "postal_code": "400042060",
            "country_code": "US",
            "telephone_number": "502-331-6002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "BETH",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010021",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3010021",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100400070",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bardstown, KY

Sources for this page

Verify at the official NPI Registry.