Courtney Elliott, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-01207 Issued in NC

Practice address

1000 Blythe Blvd
Charlotte, NC 28203-5812

Phone

(704) 355-2171

NPI assigned

Feb 21, 2008

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Carolinas Medical Center

  • Pediatrics Physician
  • Charlotte, NC
  • NPI 1528209681
  NPD
• Carolinas Medical Center

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  NPD
• Carolinas Pathology Group, PA

  • Specialist
  • Charlotte, NC
  • NPI 1689628158
  NPD
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network, Inc

  • Internal Medicine Physician
  • Lincolnton, NC
  • NPI 1184019168
  NPD
• Carolinas Medical Center

  • Surgical Critical Care Physician
  • Charlotte, NC
  • NPI 1699979732
  NPD (past)

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1043489206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9915 PARK CEDAR DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-2171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10545 Blair Rd",
            "address_2": "Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Mint Hill",
            "state": "NC",
            "postal_code": "282272800",
            "country_code": "US",
            "telephone_number": "704-863-9600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 Griffith St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Davidson",
            "state": "NC",
            "postal_code": "280369304",
            "country_code": "US",
            "telephone_number": "704-801-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2709 Water Ridge Pkwy",
            "address_2": "Building 5, Suite 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282174596",
            "country_code": "US",
            "telephone_number": "704-446-9173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "COURTNEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Ellington
• Ethen Jay Ellington
• John Kent Ellington, MD, MS
• Dianalee Elliott-Clark
• Antonisha Elliott
• Katie Nicole Elliott, PA
• Matthew Ryan Elliott, MD
• Michael David Elliott, MD
• Rebecca Lynn Elliott, MD
• Robin Elliott, MD

• All providers in Charlotte, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.