Jeffrey P McCoy, D.C.
Individual provider Active NPI Chiropractor · Shenandoah, IA
NPI 1508804485 · NPPES record last updated Oct 11, 2011
Key facts
- NPI
- 1508804485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 6219 (IA)
- Practice address
- 813 Church St
Shenandoah, IA 51601-2301 - Phone
- (712) 246-5954
- Fax
- (712) 246-3269
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Premier Healthcare of Shenandoah PC
Practice addresses (Care Compare)
813 Church St
Shenandoah, IA 51601-2301
813 Church St
Shenandoah, IA 51601-2325
Phone (712) 246-5954
813 Church St a
Shenandoah, IA 51601-2301
Hospital & facility affiliations
- Shenandoah Medical Center
- Clarinda Regional Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041111001018 | IA | Practitioner - Chiropractic | 0345214649 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6219 | IA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Healthcare of Shenandoah, P.C. | Current |
Accepting new patients | |
| Millennium Chiropractic Clinic | Chiropractor | Current | Accepting new patients |
Locations
813 Church St
Shenandoah, IA 51601
Phone (712) 246-5866
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6219 | IA | Yes |
Addresses
Primary practice location
813 Church St
Shenandoah, IA 51601-2301
Mailing address
813 Church St
Shenandoah, IA 51601-2301
Phone (712) 246-5954
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0196113 | Medicaid | IA |
Other providers in Shenandoah, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.