Medsur One Telemedicine LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MEDSUR ONE TELEMEDICINE LLC

Practice address

110 Eisenhower Court (Administrative Office Location)
1309 Coffeen Ave Ste 1200 Sheridan Wy 82801
Georgetown, TX 78633

Phone

(307) 655-1666

Fax

(512) 651-4666

NPI assigned

Mar 18, 2020

Organization subpart

No

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

Authorized official

Name

Kathleen McCoy, NURSE PRACTITION

Title

Manager

Phone

(512) 364-2151

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1568098937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 COFFEEN AVENUE STE 1200",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "82801",
            "telephone_number": "307-655-1666",
            "fax_number": "512-651-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EISENHOWER COURT (ADMINISTRATIVE OFFICE LOCATION)",
            "address_2": "1309 COFFEEN AVE STE 1200 SHERIDAN WY 82801",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78633",
            "telephone_number": "307-655-1666",
            "fax_number": "512-651-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSUR ONE TELEMEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "512-364-2151",
        "authorized_official_credential": "NURSE PRACTITION"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Michael McTague, PT, DPT, OCS
• Stephen Mark Meacham, D.D.S.
• Cody D Mead, D.O.
• Medical Billing Solutions, Inc.
• Jennifer Marie Medina, L.C.S.W.
• Deborah Meeker, P.T.
• Anya Meeks
• Sammie Mees, DC
• Adam Melcher
• Melissa L Gould LLC

• Nurse Practitioner in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.

Verify at the official NPI Registry.