Individual provider Active NPI

Michelle M McCoy, DC

  • Chiropractor
  • Jefferson Valley, NY
National Provider Identifier
1336132513
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X9201 Issued in NY
Practice address
250 E Main St
Jefferson Valley, NY 10535-1304
Phone
(914) 245-8410
Fax
(914) 245-8411
NPI assigned
Aug 23, 2005
Last updated
Aug 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X9201 NY Primary

Addresses

Primary practice location

250 E Main St
Jefferson Valley, NY 10535-1304

Mailing address

250 E Main St
PO Box 26
Jefferson Valley, NY 10535-1304
Phone (914) 245-8410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120302000589 NY Practitioner - Chiropractic 5294901575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McCoy Chiropractic P CGroup PAC ID 7719878073, 2 clinicians

Practice addresses (Care Compare)

250 E Main St
Jefferson Valley, NY 10535-1318
Phone (914) 245-8410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X9201NYMDChiropractor
009201NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
McCoy Chiropractic P C Chiropractor CurrentSince Mar 1, 2002 Accepting new patients

Organizations & group practices 1

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1336132513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "address_2": "PO BOX 26",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351304",
            "telephone_number": "914-245-8410",
            "fax_number": "914-245-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351304",
            "telephone_number": "914-245-8410",
            "fax_number": "914-245-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X9201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.