Individual provider Active NPI

Jennifer A McCoy, CRNP

  • Nurse Practitioner
  • Roaring Spring, PA
National Provider Identifier
1811021124
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP009153 Issued in PA
Practice address
111 Nason Dr
Ste 101
Roaring Spring, PA 16673-1212
Phone
(814) 224-5132
Fax
(814) 224-2903
NPI assigned
Mar 16, 2007
Last updated
Nov 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP009153 PA Primary
Occupational Health Nurse Practitioner 363LX0106X SP009153 PA

Addresses

Primary practice location

111 Nason Dr
Ste 101
Roaring Spring, PA 16673-1212

Mailing address

111 Nason Dr
Ste 101
Roaring Spring, PA 16673-1212
Phone (814) 224-5132

Other names 1

  • Jennifer A Harris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080226000796 PA Practitioner - Nurse Practitioner 5395829550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cove Family Practice, Inc.Group PAC ID 6406894906, 5 clinicians

Practice addresses (Care Compare)

111 Nason Dr
Suite 101
Roaring Spring, PA 16673-1212
Phone (814) 224-5132

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP009153PAMDOccupational Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cove Family Practice, Inc. CurrentSince Mar 3, 2008 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

111 Nason Dr
Ste 101
Roaring Spring, PA 16673
Phone (814) 224-5132

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCBFBA
  • Direct secure messaging: jennifer.mccoy@cfpi.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1811021124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NASON DR",
            "address_2": "STE 101",
            "city": "ROARING SPRING",
            "state": "PA",
            "postal_code": "166731212",
            "telephone_number": "814-224-5132",
            "fax_number": "814-224-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NASON DR",
            "address_2": "STE 101",
            "city": "ROARING SPRING",
            "state": "PA",
            "postal_code": "166731212",
            "telephone_number": "814-224-5132",
            "fax_number": "814-224-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP009153",
            "primary": true
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "PA",
            "license": "SP009153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HARRIS",
            "middle_name": "A",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roaring Spring, PA

Sources for this page

Verify at the official NPI Registry.