Individual provider Active NPI

Rachael Lee McCoy, D.C.

  • Chiropractor
  • Sault Sainte Marie, MI
National Provider Identifier
1376671016
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008439 Issued in MI
Practice address
2717 Ashmun St
Sault Sainte Marie, MI 49783-3753
Phone
(906) 253-4000
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008439 MI Primary

Addresses

Primary practice location

2717 Ashmun St
Sault Sainte Marie, MI 49783-3753

Mailing address

2717 Ashmun St
Sault Sainte Marie, MI 49783-3753
Phone (906) 253-4000

Other identifiers 1

IdentifierTypeStateIssuer
95-0-A7-5006-0OtherMIBLUE CROSS & BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101221000698 MI Practitioner - Chiropractic 0840272548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bordertown Chiropractic P.C.Group PAC ID 2769464460, 3 clinicians

Practice addresses (Care Compare)

2717 Ashman St
Sault Sainte Marie, MI 49783-3753
Phone (906) 253-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301008439MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bordertown Chiropractic P.C. Chiropractor CurrentSince Mar 16, 2002 Accepting new patients

Locations

2717 Ashmun St
Sault South Marie, MI 49783
Phone (906) 253-4000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376671016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 ASHMUN ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833753",
            "telephone_number": "906-253-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 ASHMUN ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833753",
            "telephone_number": "906-253-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "RACHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "95-0-A7-5006-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sault Sainte Marie, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.