Courtney Brooke Addison, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3014877 Issued in KY

Practice address

1484 Lakeside Dr
Jackson, KY 41339-6555

Phone

(606) 666-9950

Fax

(606) 666-9136

NPI assigned

Nov 23, 2020

Last updated

Nov 4, 2022By the provider in NPPES

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 KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Juniper Health IncGroup PAC ID 2961453618, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kentucky River Medical Center Hospital, Jackson, KY, CCN 181334

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: courtney.addison.p1@direct.juniperhealth.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Juniper Health Inc

  dba Lee County Family Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Beattyville, KY
  • NPI 1407818628
  Medicare reassignment Care Compare group NPD
• Juniper Health Inc

  dba Juniper Health Elliott County

  • Federally Qualified Health Center (FQHC)
  • Sandy Hook, KY
  • NPI 1669014627
  NPD
• QPS LLC

  dba Elliott Pharmacy

  • Community/Retail Pharmacy
  • Sandy Hook, KY
  • NPI 1538901186
  NPD
• Juniper Health Inc

  dba Juniper Morgan County

  • Federally Qualified Health Center (FQHC)
  • West Liberty, KY
  • NPI 1447791512
  NPD (past)
• Juniper Health Inc

  dba Breathitt County Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson, KY
  • NPI 1467417691
  NPD (past)
• Juniper Health, Inc

  dba JHI Wolfe County Family Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Campton, KY
  • NPI 1962823393
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jackson Hospital Corporation

  dba Kentucky River Medical Center

  • Critical Access Hospital
  • Jackson, KY
  • NPI 1346247962
  Care Compare affiliation

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1104420835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "413110690",
            "telephone_number": "606-464-0151",
            "fax_number": "606-464-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1484 LAKESIDE DR",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413396555",
            "telephone_number": "606-666-9950",
            "fax_number": "606-666-9136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1219 W Main St",
            "address_purpose": "LOCATION",
            "city": "West Liberty",
            "state": "KY",
            "postal_code": "414722161",
            "country_code": "US",
            "telephone_number": "606-743-4808",
            "fax_number": "606-743-4716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 Plummer St",
            "address_purpose": "LOCATION",
            "city": "Campton",
            "state": "KY",
            "postal_code": "413019381",
            "country_code": "US",
            "telephone_number": "606-668-7385",
            "fax_number": "606-668-7009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "308 N KY 7",
            "address_purpose": "LOCATION",
            "city": "Sandy Hook",
            "state": "KY",
            "postal_code": "41171",
            "country_code": "US",
            "telephone_number": "606-738-9785",
            "fax_number": "859-317-2148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Grand Avenue",
            "address_purpose": "LOCATION",
            "city": "Beattyville",
            "state": "KY",
            "postal_code": "41311",
            "country_code": "US",
            "telephone_number": "606-464-2401",
            "fax_number": "606-464-3290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADDISON",
        "first_name": "COURTNEY",
        "middle_name": "BROOKE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron K. Jonan Memorial Clinic Inc. (Aaron Jonan Memorial Clinic)
• June Elizabeth Abadilla
• Melecio G Abordo Jr., M.D.
• Marcia Adams
• Advanced Surgical Specialists of Ky, PLLC
• Cesar Ocampo Agtarap, M.D.
• Sreenivasa Reddy Alla, M.D.
• American Homepatient, Inc.
• Appalachian Post Acute LLC (Appalachian Post Acute)

• Family Nurse Practitioner in Jackson, KY
• Providers in Jackson, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.