Individual provider Active NPI

Mia McCoy, APN

  • Pediatric Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1841684636
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3-000910 Issued in AL
Practice address
1601 Center St
Mobile, AL 36604-1541
Phone
(251) 410-5437
Fax
(251) 434-3783
NPI assigned
Mar 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APN19723 TN
Pediatric Nurse Practitioner 363LP0200X 3-000910 AL Primary

Addresses

Primary practice location

1601 Center St
Mobile, AL 36604-1541

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (251) 434-3626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220812000645 AL Practitioner - Nurse Practitioner 8628396645 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN19723TNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Physician Billing Services LLC CurrentSince Jun 15, 2022 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Jun 15, 2022 Accepting new patients
University of South Alabama Past Accepting new patients

Locations

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

1601 Center St
Mobile, AL 36604
Phone (251) 410-5437

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1841684636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "251-434-3626",
            "fax_number": "251-445-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CENTER ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041541",
            "telephone_number": "251-410-5437",
            "fax_number": "251-434-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "MIA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "APN19723",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "3-000910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.