Individual provider Active NPI

James M. McCoy, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Knoxville, TN
National Provider Identifier
1619967692
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS0000003411 Issued in TN
Practice address
1928 Alcoa Hwy
Suite 305
Knoxville, TN 37920-1502
Phone
(865) 305-6625
Fax
(865) 305-6628
NPI assigned
Oct 21, 2005
Last updated
Oct 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS0000003411 TN Primary

Addresses

Primary practice location

1928 Alcoa Hwy
Suite 305
Knoxville, TN 37920-1502

Mailing address

PO Box 440109
Nashville, TN 37244-0109
Phone (865) 670-6199

Other identifiers 1

IdentifierTypeStateIssuer
3225200MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090805000741 TN Practitioner - PathologyPractitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 3173676533 Reassigns benefits to 1 organization
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS0000003411TNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
University Pathologists, P.C. CurrentSince Oct 1, 2001 Accepting new patients

Locations

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

Dept 888075
Knoxville, TN 37995

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1619967692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440109",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440109",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 ALCOA HWY",
            "address_2": "SUITE 305",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201502",
            "telephone_number": "865-305-6625",
            "fax_number": "865-305-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "JAMES",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS0000003411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3225200",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.