Organization Active NPI

Wendy McCoy PC

  • Chiropractor
  • Clarinda, IA
National Provider Identifier
1962586826
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06320 Issued in IA
Legal business name
WENDY MCCOY PC
Practice address
1205 S 16TH St
Clarinda, IA 51632-2988
Phone
(712) 542-3056
Fax
(712) 542-3056
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Mrs. Wendy Lynnae McCoy, D.C.
Title
Chiropractor
Phone
(712) 542-3056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 06320 IA Primary

Addresses

Primary practice location

1205 S 16TH St
Clarinda, IA 51632-2988

Mailing address

1205 S 16TH St
Clarinda, IA 51632-2988
Phone (712) 542-3056

Other identifiers 1

IdentifierTypeStateIssuer
2209130MedicaidIA

Other names 1

  • Millennium Chiropractic Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071002000011 IA Part B Supplier - Clinic/Group Practice 3173618444 Receives reassigned benefits from 1 practitioner
Practice locations: Clarinda, IA

National Provider Directory

National Provider Directory

Locations

1205 S 16th St
Clarinda, IA 51632
Phone (712) 542-3056

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1962586826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 S 16TH ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322988",
            "telephone_number": "712-542-3056",
            "fax_number": "712-542-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 S 16TH ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322988",
            "telephone_number": "712-542-3056",
            "fax_number": "712-542-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENDY MCCOY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "LYNNAE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "712-542-3056",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2209130",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Millennium Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarinda, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.