Individual provider Active NPI

David Mac McCoy III, APRN-CNP, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1457017154
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1058909 Issued in TX
Practice address
1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone
(817) 250-2000
NPI assigned
Nov 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1058909 TX Primary

Addresses

Primary practice location

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122

Mailing address

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 761-7742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220325002256 TX Practitioner - Nurse Practitioner 4183019292 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1325 Pennsylvania Ave
Suite 690
Fort Worth, TX 76104-2133
Phone (817) 250-7030

Hospital & facility affiliations

  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Sep 1, 2023 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Sep 1, 2023 Accepting new patients
Dallas Pulmonary & Critical Care PA Acute Care CurrentSince Dec 27, 2022 Accepting new patients
Texas Health Physicians Group Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

221 W Colorado Blvd
Ste 525
Dallas, TX 75208
Phone (214) 956-4525

800 5th Ave
Ste 400
Fort Worth, TX 76104
Phone (817) 702-9100

1325 Pennsylvania Ave
Ste 690
Fort Worth, TX 76104
Phone (817) 761-7740

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

5605 N MacArthur Blvd
Ste 740
Irving, TX 75038
Phone 2149605681 ext. 75

Interoperability endpoints

  • Direct secure messaging: dmccoy1829119@direct.texashealth.org

Organizations & group practices 5

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 1

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": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1457017154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042122",
            "telephone_number": "817-761-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042122",
            "telephone_number": "817-250-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "DAVID",
        "middle_name": "MAC",
        "name_suffix": "III",
        "credential": "APRN-CNP, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-17",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1058909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.