Ms Rekita Dechelle Mccoy, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" physician in Pearl, Mississippi. Her current practice location is
200 Riverwind Dr Ste 104, Pearl, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 345-4044.
Ms Rekita Dechelle Mccoy is licensed to practice in Mississippi (license number 902513) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1215437058.
Physician's Profile
| Full Name | Ms Rekita Dechelle Mccoy |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 200 Riverwind Dr Ste 104, Pearl, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1215437058
- Provider Enumeration Date: 02/19/2018
- Last Update Date: 09/03/2022
Medicare PECOS Information:
- PECOS PAC ID: 3476815671
- Enrollment ID: I20180328002258
Medical Identifiers
Medical identifiers for Ms Rekita Dechelle Mccoy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215437058 | NPI | - | NPPES |
| 1215437058 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | MCCO-RFN3U1 (Mississippi) | Secondary |
| 207Q00000X | Family Medicine | F01180598 (Mississippi) | Secondary |
| 363L00000X | Nurse Practitioner | 902513 (Mississippi) | Secondary |
| 363LP0200X | Nurse Practitioner - Pediatrics | 902513 (Mississippi) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 902513 (Mississippi) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Rekita Dechelle Mccoy allows following entities to bill medicare on her behalf.
| Entity Name | Fast Pace Mississippi Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447769559
PECOS PAC ID: 3678832029
Enrollment ID: O20180111000291 |
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| Entity Name | Community Care Health Network Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1619368842
PECOS PAC ID: 8527324151
Enrollment ID: O20210520000556 |
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| Entity Name | Divinity Pediatric Clinic, Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629741152
PECOS PAC ID: 2062810047
Enrollment ID: O20211005002232 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Rekita Dechelle Mccoy is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Rekita Dechelle Mccoy, NURSE PRACTITIONER
200 Riverwind Dr Ste 104,
Pearl, MS 39208-5652
Ph: (601) 345-4044 | Ms Rekita Dechelle Mccoy, NURSE PRACTITIONER
200 Riverwind Dr Ste 104,
Pearl, MS 39208-5652
Ph: (601) 345-4044 |
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