Individual provider Active NPI

Cody Lance McCoy, AGACNP

  • Acute Care Nurse Practitioner
  • Longview, TX
National Provider Identifier
1710625975
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1079757 Issued in TX
Practice address
707 Hollybrook Dr Ste 200
Longview, TX 75605-2410
Phone
(903) 291-6191
NPI assigned
May 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 1079757 TX Primary

Addresses

Primary practice location

707 Hollybrook Dr Ste 200
Longview, TX 75605-2410

Mailing address

340 Cross Creek Rd
Longview, TX 75602-7604
Phone (903) 399-4128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220829003785 TX Practitioner - Nurse Practitioner 0446487300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Clinics of LongviewGroup PAC ID 7214016559, 38 clinicians

Practice addresses (Care Compare)

1009 N 4TH St
Suite a
Longview, TX 75601-4768
Phone (903) 757-3808

2901 4TH St
Longview, TX 75605-5128
Phone (903) 758-1818

707 Hollybrook Dr
Longview, TX 75605-2410
Phone (903) 757-6042

Hospital & facility affiliations

  • Longview Regional Medical Center Hospital, Longview, TX, CCN 450702

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as apm
Quality
79.07
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Clinics of Longview CurrentSince Jun 27, 2022 Accepting new patients
Diagnostic Clinic of Longview PA Past Accepting new patients

Locations

707 Hollybrook Dr
Ste 200
Longview, TX 75605
Phone (903) 291-6191

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 1

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1710625975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 CROSS CREEK RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756027604",
            "telephone_number": "903-399-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR STE 200",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052410",
            "telephone_number": "903-291-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "CODY",
        "middle_name": "LANCE",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1079757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.