Organization Active NPI

Norman G. McKoy MD & Associates PA

  • Family Medicine Physician
  • Mitchellville, MD
National Provider Identifier
1801047055
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D35947 Issued in MD
Legal business name
NORMAN G. MCKOY MD & ASSOCIATES PA
Practice address
10274 Lake Arbor Way
Suite 202
Mitchellville, MD 20721-3146
Phone
(301) 336-9065
Fax
(301) 336-6909
NPI assigned
Oct 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Authorized official

Name
Dr. Norman G. McKoy, M.D.NPI 1699840355
Title
Medical Doctor
Phone
(301) 336-9065

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X D35947 MD Primary

Addresses

Primary practice location

10274 Lake Arbor Way
Suite 202
Mitchellville, MD 20721-3146

Mailing address

10274 Lake Arbor Way
Suite 202
Mitchellville, MD 20721-3146
Phone (301) 336-9065

Other identifiers 4

IdentifierTypeStateIssuer
0733-0001OtherDCBLUECROSS BLUESHIELD-DC
0660019-00MedicaidMD
06980OtherMDAMERICAID
7946OtherMDBLUECROSS BLUESHIELD OF MARYLAND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081007000871 DC Part B Supplier - Clinic/Group Practice 1355419011 Receives reassigned benefits from 1 practitioner
Practice locations: Bowie, MD

National Provider Directory

National Provider Directory

Locations

10274 Lake Arbor Way
Ste 202
Mitchellville, MD 20721
Phone (301) 336-9065

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407369600000",
    "number": "1801047055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10274 LAKE ARBOR WAY",
            "address_2": "SUITE 202",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207213146",
            "telephone_number": "301-336-9065",
            "fax_number": "301-336-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10274 LAKE ARBOR WAY",
            "address_2": "SUITE 202",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207213146",
            "telephone_number": "301-336-9065",
            "fax_number": "301-336-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORMAN G. MCKOY MD & ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2014-08-07",
        "status": "A",
        "authorized_official_last_name": "MCKOY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "301-336-9065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D35947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD-DC",
            "identifier": "0733-0001",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0660019-00",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAID",
            "identifier": "06980",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF MARYLAND",
            "identifier": "7946",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchellville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.