Active NPI
Davielle Justine McCoy, PT, DPT
- Physical Therapist
- Warrensburg, MO
National Provider Identifier
1467988402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2017026959
- Practice address
- 540 E Young Ave
Ste E
Warrensburg, MO 64093-1231 - Phone
- (660) 262-4795
- Fax
- (660) 747-0347
- NPI assigned
- May 11, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2017026959 | MO | Primary |
Addresses
Primary practice location
540 E Young Ave
Ste E
Warrensburg, MO 64093-1231
Mailing address
6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017026959 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1467988402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6397 LEE HWY STE 300",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374212564",
"telephone_number": "423-238-7217",
"fax_number": "423-238-3473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 E YOUNG AVE",
"address_2": "STE E",
"city": "WARRENSBURG",
"state": "MO",
"postal_code": "640931231",
"telephone_number": "660-262-4795",
"fax_number": "660-747-0347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "DAVIELLE",
"middle_name": "JUSTINE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-11",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2017026959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warrensburg, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.