Courtney Cassandra Peck, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F352308 Issued in NY

Practice address

6 Executive Park Dr
Albany, NY 12203-3791

Phone

(518) 641-6319

Fax

(518) 641-6850

NPI assigned

Jun 30, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370
  Medicare reassignment NPD
• Community Care Physicians, PC

  dba Community Care Lab Care

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1023380714
  NPD (past)

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1003593146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 EXECUTIVE PARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033791",
            "telephone_number": "518-641-6319",
            "fax_number": "518-641-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "COURTNEY",
        "middle_name": "CASSANDRA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F352308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleanor Pearlman, LCSWR
• Martin Victor Pearlmon, LCSW CASAC
• Darren Pearson
• Teteisha Tianna Pearson, CRNA
• Samuel Peaslee
• Bruce A Peckage, DPM
• Pediatric Dentistry of Albany, PLLC
• Asia Peek, MD
• Jennifer E Pelesz, PA
• Nicole Marie Pellegrini, PA

• Family Nurse Practitioner in Albany, NY
• Providers in Albany, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.