Active NPI
Norman G. McKoy MD & Associates PA
- Family Medicine Physician
- Mitchellville, MD
National Provider Identifier
1801047055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D35947
- 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
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.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0733-0001 | Other | DC | BLUECROSS BLUESHIELD-DC |
| 0660019-00 | Medicaid | MD | |
| 06980 | Other | MD | AMERICAID |
| 7946 | Other | MD | BLUECROSS BLUESHIELD OF MARYLAND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
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.