Individual provider Active NPI

Courtney Lynn Miles

  • Family Nurse Practitioner
  • Booneville, MS
National Provider Identifier
1003775883
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903340 Issued in MS
Practice address
1081 Highway 30 E
Booneville, MS 38829-7970
Phone
(662) 416-9571
NPI assigned
Jan 19, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 903340 MS Primary

Addresses

Primary practice location

1081 Highway 30 E
Booneville, MS 38829-7970

Mailing address

1081 Highway 30 E
Booneville, MS 38829-7970

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260311003694 TN Practitioner - Nurse Practitioner 5294218871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

505 E Main St
Henderson, TN 38340-2415
Phone (731) 435-1488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41059TNMDPediatrics Physician
903340MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 18, 2026 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 18, 2026 Accepting new patients
Upperline Healthcare, PC CurrentSince Feb 18, 2026 Accepting new patients
Upperline Healthcare, PC CurrentSince Feb 18, 2026 Accepting new patients

Locations

505 E Main St
Henderson, TN 38340
Phone (731) 435-1488

Organizations & group practices 4

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": "1768780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1003775883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 HIGHWAY 30 E",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388297970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 HIGHWAY 30 E",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388297970",
            "telephone_number": "662-416-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-19",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, MS

Sources for this page

Verify at the official NPI Registry.