Individual provider Active NPI

Courtney King

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1013273929
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP026602 Issued in PA
Practice address
1026 E Sydney St
Philadelphia, PA 19150-3423
Phone
(484) 548-0115
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X SL010743 PA
Family Nurse Practitioner 363LF0000X SP026602 PA Primary

Addresses

Primary practice location

1026 E Sydney St
Philadelphia, PA 19150-3423

Mailing address

1026 E Sydney St
Philadelphia, PA 19150-3423
Phone (484) 548-0115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240815000699 PA Practitioner - Nurse Practitioner 3678011178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

225 E City Ave
Suite 109
Bala Cynwyd, PA 19004-1724
Phone (215) 503-3838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SL010743PAMDSpecialist
SP026602PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince May 19, 2025 Accepting new patients
Methodist Associates in Healthcare, Inc Current Accepting new patients
Methodist Associates in Healthcare, Inc. CurrentSince May 19, 2025 Accepting new patients
Therapyties PastSince Apr 27, 2025 Accepting new patients

Locations

225 E City Line Ave
Ste 109
Bala Cynwyd, PA 19004
Phone (215) 503-3838

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

Organizations & group practices 5

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1013273929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 E SYDNEY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503423",
            "telephone_number": "484-548-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 E SYDNEY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503423",
            "telephone_number": "484-548-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "SL010743",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP026602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.