Individual provider Active NPI

Jiyoung Ahn McCoy, APRN-CNP

  • Acute Care Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1669958930
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.023239 Issued in OH
Practice address
1581 Dodd Dr
Columbus, OH 43210-1257
Phone
(614) 293-2101
Fax
(614) 293-9155
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.023239 OH Primary

Addresses

Primary practice location

1581 Dodd Dr
Columbus, OH 43210-1257

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-2101

Other identifiers 1

IdentifierTypeStateIssuer
0308836MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180904001922 OH Practitioner - Nurse Practitioner 4385994870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Surgery, LLCGroup PAC ID 0941105266, 207 clinicians

Practice addresses (Care Compare)

1581 Dodd Dr
Columbus, OH 43210-1257
Phone (614) 293-2101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.023239OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Healthproviders Two LLC CurrentSince Jan 1, 2021 Accepting new patients
Osu Surgery, LLC CurrentSince Feb 1, 2021 Accepting new patients
Mount Carmel Healthproviders Two LLC CurrentSince Jan 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

300 W 10th Ave
Columbus, OH 43210
Phone (614) 293-3276

2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054

1581 Dodd Dr
Columbus, OH 43210
Phone (614) 293-2101

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400

477 Cooper Rd
Ste 300
Westerville, OH 43081
Phone (614) 898-8808

Interoperability endpoints

  • Direct secure messaging: jmccoy1154952@direct.trinity-health.org

Organizations & group practices 4

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1669958930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-2101",
            "fax_number": "614-293-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1581 DODD DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101257",
            "telephone_number": "614-293-2101",
            "fax_number": "614-293-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "JIYOUNG",
        "middle_name": "AHN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.023239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0308836",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.