Individual provider Active NPI

Ebony Symone' McCoy, FNP-C

  • Family Nurse Practitioner
  • Madison, MS
National Provider Identifier
1942817838
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904386 Issued in MS
Practice address
1520 Highland Colony Pkwy
Madison, MS 39110-7723
Phone
(769) 289-6100
NPI assigned
Sep 25, 2020
Last updated
Mar 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904386 MS Primary

Addresses

Primary practice location

1520 Highland Colony Pkwy
Madison, MS 39110-7723

Mailing address

8613 Ms Highway 12
Ackerman, MS 39735-8917
Phone (662) 285-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20210526001496 MS Practitioner - Nurse Practitioner 2466851373 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seshadri Raju, M.D., PA.Group PAC ID 3971674896, 8 clinicians

Practice addresses (Care Compare)

971 Lakeland Dr
Suite 401
Jackson, MS 39216-4607
Phone (601) 939-4230

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.54 of 100Reported as group
Quality
74.69
Improvement activities
40
Cost
68.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seshadri Raju, M.D., PA. CurrentSince May 2, 2024 Accepting new patients
Choctaw Regional Medical Center Current Accepting new patients

Locations

64 N Louisville St
Ackerman, MS 39735
Phone (662) 285-9050

8613 MS Highway 12
Ackerman, MS 39735
Phone (662) 285-4400

971 Lakeland Dr
Ste 401
Jackson, MS 39216
Phone (601) 939-4230

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.

Hospital & facility affiliations 3

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": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1942817838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8613 MS HIGHWAY 12",
            "city": "ACKERMAN",
            "state": "MS",
            "postal_code": "397358917",
            "telephone_number": "662-285-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 HIGHLAND COLONY PKWY",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107723",
            "telephone_number": "769-289-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "EBONY",
        "middle_name": "SYMONE'",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

Verify at the official NPI Registry.