Active NPI
Tanja McCoy, LPN
- Licensed Practical Nurse
- Louisville, OH
National Provider Identifier
1962570804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN079519
- Practice address
- 1630 2 East Main Street
Louisville, OH 44641 - Phone
- (216) 215-0919
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN079519 | OH | Primary |
Addresses
Primary practice location
1630 2 East Main Street
Louisville, OH 44641
Mailing address
PO Box 18648
Cleveland HTS, OH 44118-0648
Phone (216) 215-0919
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2239876 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN079519 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1962570804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18648",
"city": "CLEVELAND HTS",
"state": "OH",
"postal_code": "441180648",
"telephone_number": "216-215-0919",
"fax_number": "216-583-9003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 2 EAST MAIN STREET",
"city": "LOUISVILLE",
"state": "OH",
"postal_code": "44641",
"telephone_number": "216-215-0919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "TANJA",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN079519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2239876",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.