Active NPI
Cassandra Evon McCoy
- Athletic Trainer
- Tulsa, OK
National Provider Identifier
1528598232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1146
- Practice address
- 6475 S Yale Ave Ste 301
Tulsa, OK 74136-7815 - Phone
- (918) 494-9300
- Fax
- (918) 494-9355
- NPI assigned
- Jun 14, 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1146 | OK | Primary |
Addresses
Primary practice location
6475 S Yale Ave Ste 301
Tulsa, OK 74136-7815
Mailing address
1108 W Pearl St
Collinsville, OK 74021-2055
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1146 | OK | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582156800000",
"number": "1528598232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 W PEARL ST",
"city": "COLLINSVILLE",
"state": "OK",
"postal_code": "740212055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6475 S YALE AVE STE 301",
"city": "TULSA",
"state": "OK",
"postal_code": "741367815",
"telephone_number": "918-494-9300",
"fax_number": "918-494-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "CASSANDRA",
"middle_name": "EVON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-14",
"last_updated": "2020-02-20",
"certification_date": "2020-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OK",
"license": "1146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.