Individual provider Active NPI

Courtney Anne Gouge, PA-C

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1093900276
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01242 Issued in NC
Practice address
2330 Brookford Blvd
Hickory, NC 28602-9180
Phone
(828) 330-2103
Fax
(828) 294-0131
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-01242 NC Primary
Medical Physician Assistant 363AM0700X 0110002616 VA

Addresses

Primary practice location

2330 Brookford Blvd
Hickory, NC 28602-9180

Mailing address

PO Box 829
Hildebran, NC 28637-0829
Phone (828) 397-3522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20151120002746 NC Practitioner - Physician Assistant 2668772773 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians

Practice addresses (Care Compare)

Statesville, NC 28677
Phone (704) 838-2182

1540 E Broad St
Statesville, NC 28625-4302

766 Hartness Rd
Suite B
Statesville, NC 28677-3479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110002616VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Urgent Care of Mountain View LLC CurrentSince Jul 13, 2026 Accepting new patients
Iredell Physician Network LLC CurrentSince Apr 15, 2023 Accepting new patients
Iredell Physician Network LLC CurrentSince Apr 15, 2023 Accepting new patients
Morning Star Family Medicine PC PastSince Apr 16, 2023 Accepting new patients

Locations

2330 Brookford Blvd
Hickory, NC 28602
Phone (828) 330-2103

1540 E Broad St
Statesville, NC 28625
Phone (704) 230-4382

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

Organizations & group practices 8

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1093900276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 829",
            "city": "HILDEBRAN",
            "state": "NC",
            "postal_code": "286370829",
            "telephone_number": "828-397-3522",
            "fax_number": "828-397-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 BROOKFORD BLVD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029180",
            "telephone_number": "828-330-2103",
            "fax_number": "828-294-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGE",
        "first_name": "COURTNEY",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01242",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002616",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.