Individual provider Active NPI

Jacqueline A McCoy, ARNP MS

  • Registered Nurse
  • Edmonds, WA
National Provider Identifier
1396725263
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00050601 Issued in WA
Practice address
555 Dayton St
Ste C
Edmonds, WA 98020
Phone
(425) 774-4673
Fax
(425) 774-0690
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00050601 WA Primary
Nurse Practitioner 363L00000X AP30000243 WA

Addresses

Primary practice location

555 Dayton St
Ste C
Edmonds, WA 98020

Mailing address

555 Dayton St
Ste C
Edmonds, WA 98020
Phone (425) 774-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN00050601WAMDRegistered Nurse
AP30000243WAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1396725263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 DAYTON ST",
            "address_2": "STE C",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98020",
            "telephone_number": "425-774-4673",
            "fax_number": "425-774-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 DAYTON ST",
            "address_2": "STE C",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98020",
            "telephone_number": "425-774-4673",
            "fax_number": "425-774-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "JACQUELINE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "ARNP MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00050601",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30000243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.