Shelley J. McCoy, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21064 Issued in NE

Practice address

2 W 42ND Street
Suite 2800
Scottsbluff, NE 69361-4660

Phone

(308) 630-7977

Fax

(308) 630-1028

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Scottsbluff Operations LLC

  • Skilled Nursing Facility
  • Scottsbluff, NE
  • NPI 1447711890
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1912081605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1498",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693631498",
            "telephone_number": "308-630-7977",
            "fax_number": "308-630-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W 42ND STREET",
            "address_2": "SUITE 2800",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614660",
            "telephone_number": "308-630-7977",
            "fax_number": "308-630-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "SHELLEY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "21064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "35049",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE PROVIDER",
            "identifier": "24554",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39200784100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellie Buckley May, RD
• Janine Mayo, PLMHP
• Cathy Mazero
• Laura McCart
• Chantel Angelica McCathern
• Cynthia K McCumbers, N.P
• Brittany Christine McDonald, APRN
• Ashley McDonnell, PHARMD
• Eleanor McKnight
• Dawn Elizabeth McKown, PT, ATC

• Family Medicine Physician in Scottsbluff, NE
• Providers in Scottsbluff, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.