Courtney Brooke Addison, APRN
Individual provider Active NPI Family Nurse Practitioner · Jackson, KY
NPI 1104420835 · NPPES record last updated Nov 4, 2022
Key facts
- NPI
- 1104420835
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3014877 (KY)
- Practice address
- 1484 Lakeside Dr
Jackson, KY 41339-6555 - Phone
- (606) 666-9950
- Fax
- (606) 666-9136
- NPI assigned
- Nov 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Juniper Health Inc
Practice addresses (Care Compare)
1484 Lakeside Dr
Jackson, KY 41339-7370
Phone (606) 666-9950
Hospital & facility affiliations
- Kentucky River Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221215002485 | KY | Practitioner - Family Practice | 7911376892 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3014877 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Juniper Health Inc | Current | Accepting new patients | |
| Juniper Health Inc | Current |
Accepting new patients | |
| QPS LLC | Current |
Accepting new patients | |
| Juniper Health, Inc | Past | Accepting new patients | |
| Juniper Health Inc | Past | Accepting new patients | |
| Juniper Health Inc | Past | Accepting new patients |
Locations
1665 Highway 11 S
Beattyville, KY 41311
Phone (606) 464-2401
599 Lee Ave
Beattyville, KY 41311
Phone (606) 464-2401
1025 Grand Ave
Beattyville, KY 41311
Phone (606) 464-2401
10355 Highway 30 W
Booneville, KY 41314
Phone (606) 666-9950
2085 US Highway 460 E
Frenchburg, KY 40322
Phone (606) 768-3725
11134 KY Highway 191
Hazel Green, KY 41332
Phone (606) 662-8252
1484 Lakeside Dr
Jackson, KY 41339
Phone (606) 666-9950
2307 Bobcat Ln
Jackson, KY 41339
Phone (606) 666-9950
940 Highland Ave
Jackson, KY 41339
Phone (606) 666-4979
1745 Ky 715
Rogers, KY 41365
Phone (606) 668-7385
Interoperability endpoints
- courtney.addison.p1@direct.juniperhealth.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3014877 | KY | Yes |
Addresses
Primary practice location
1484 Lakeside Dr
Jackson, KY 41339-6555
Mailing address
PO Box 690
Beattyville, KY 41311-0690
Phone (606) 464-0151
Other practice location 1
1219 W Main St
West Liberty, KY 41472-2161
Phone (606) 743-4808
Other practice location 2
202 Plummer St
Campton, KY 41301-9381
Phone (606) 668-7385
Other practice location 3
308 N Ky 7
Sandy Hook, KY 41171
Phone (606) 738-9785
Other practice location 4
1025 Grand Avenue
Beattyville, KY 41311
Phone (606) 464-2401
Other providers in Jackson, KY
- Aaron K. Jonan Memorial Clinic Inc.
- June Elizabeth Abadilla
- Melecio G Abordo Jr.
- Marcia Adams
- Advanced Surgical Specialists of Ky, PLLC
- Cesar Ocampo Agtarap
- Sreenivasa Reddy Alla
- American Homepatient, Inc.
- Appalachian Post Acute LLC
All providers in Jackson, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.