Individual provider Active NPI

Dawn Maria McCoy, MD

  • Pediatrics Physician
  • Virginia Beach, VA
National Provider Identifier
1952393043
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101052928 Issued in VA
Practice address
6477 College Park SQ
Ste 118
Virginia Beach, VA 23464-3611
Phone
(757) 420-6218
Fax
(757) 420-0487
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101052928 VA Primary

Addresses

Primary practice location

6477 College Park SQ
Ste 118
Virginia Beach, VA 23464-3611

Mailing address

6477 College Park SQ
Ste 118
Virginia Beach, VA 23464-3611
Phone (757) 420-6218

Other identifiers 1

IdentifierTypeStateIssuer
6718272MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160129000202 VA Practitioner - Pediatric Medicine 3375846090 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Pediatrics CurrentSince Jan 5, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Jan 5, 2016 Accepting new patients
Tidewater Ped. Consultants, PC Pediatrics Past Accepting new patients

Locations

8644 Sudley Rd
#220
Manassas, VA 20110

6477 College Park Sq
Ste 118
Virginia Beach, VA 23464
Phone (757) 420-6218

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2533/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1952393043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6477 COLLEGE PARK SQ",
            "address_2": "STE 118",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643611",
            "telephone_number": "757-420-6218",
            "fax_number": "757-420-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6477 COLLEGE PARK SQ",
            "address_2": "STE 118",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643611",
            "telephone_number": "757-420-6218",
            "fax_number": "757-420-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "DAWN",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101052928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6718272",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.