NPIMap

Individual provider Active NPI

Mark McCoy, DPT

  • Physical Therapist
  • West Sacramento, CA
National Provider Identifier
1366541740
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11110 Issued in CA
Practice address
1550 Harbor Blvd Ste 120
West Sacramento, CA 95691-3826
Phone
(916) 375-1667
Fax
(191) 637-5161
NPI assigned
Sep 21, 2006
Last updated
Mar 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT11110 CA Primary

Addresses

Primary practice location

1550 Harbor Blvd Ste 120
West Sacramento, CA 95691-3826

Mailing address

5207 J St
Sacramento, CA 95819-3941
Phone (916) 277-8269

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060302000272 CA Practitioner - Physical Therapist in Private Practice 0345148243 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11110CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western Physical Therapy, Inc. Physical Therapist CurrentSince Oct 10, 2022 Accepting new patients
Swanson Schaack Physical Therapy Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Schaack Physical Therapy PC Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Western Physical Therapy, Inc. Physical Therapist CurrentSince Oct 10, 2022 Accepting new patients
Western Physical Therapy, Inc. Physical Therapist Current Accepting new patients
The Physical Therapy Clinics, Inc. Physical Therapist Past Accepting new patients
Cicero and Hendricks Physical Therapy Physical Therapist Past Accepting new patients
The Physical Therapy Clinics, Inc. Physical Therapist Past Accepting new patients
The Physical Therapy Clinics, Inc. Physical Therapist Past Accepting new patients
The Physical Therapy Clinics. Inc. Physical Therapist Past Accepting new patients

Locations

111 Woodmere Rd
Ste 270
Folsom, CA 95630

2330 E Bidwell St
Ste 130
Folsom, CA 95630

801 Sterling Pkwy
Ste 150
Lincoln, CA 95648
Phone (916) 543-7900

6125 King Rd
Ste 102
Loomis, CA 95650
Phone (916) 652-5700

1620 Lead Hill Blvd
Ste 200
Roseville, CA 95661
Phone (916) 353-2270

Organizations & group practices 11

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1366541740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5207 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193941",
            "telephone_number": "916-277-8269",
            "fax_number": "916-277-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 HARBOR BLVD STE 120",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913826",
            "telephone_number": "916-375-1667",
            "fax_number": "191-637-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "MARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.