Kelly Marie McCoy, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

15476 Dedeaux Rd.
Suite B
Gulfport, MS 39503

Phone

(228) 679-3001

Fax

(228) 679-3039

NPI assigned

Feb 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Kelly Marie Kuluz Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ideal Physical Therapy of Texas LLCGroup PAC ID 0547583809, 359 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.56 of 100Reported as group

Quality

89.48

Improvement activities

40

Cost

71.16

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Ideal Physical Therapy of Texas LLC

  • Physical Therapist
  • Plano, TX
  • NPI 1538573746
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1700858826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15476 DEDEAUX RD.",
            "address_2": "SUITE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39503",
            "telephone_number": "228-679-3001",
            "fax_number": "228-679-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MS",
            "license": "OT3034",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700858826",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "KULUZ",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stefan McClellan
• Haley McCool, MD
• Marly J McCormack, LMSW
• Johnathon Beaux McCormick Sr., D.M.D.
• Carolyn Lewis McCorvey, LCSW
• Richard McCrary, M.D.
• Meddol Regina McCray, NP
• Kelli Kristine McCreight, NP
• Courtney McDonald
• Monica McDonald, PMHNP

• Occupational Therapist in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.