Jacqueline McCoy-McCullough

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

License

A-3519544 Issued in FL

Practice address

2900 Veterans Way
Melbourne, FL 32940-8007

Phone

(407) 492-3376

NPI assigned

Sep 6, 2023

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1932985967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 WENTHROP CIR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554743",
            "telephone_number": "321-863-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "407-492-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY-MCCULLOUGH",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "FL",
            "license": "A-3519544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel McCleve, APRN
• Brittnee McClure, B.A.
• Dana E McClure, M.A. CCC-SLP
• Joseph A McClure, MD
• Laura Beth McClure, APRN, FNP-C
• Gwunque McCoy
• James McCoy
• Marti Jo McCoy, LCSW
• Stuart William McCranels, D.C.
• Reagan Rae McCray

• Health & Wellness Coach in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Health & Wellness Coach in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.