NPIMap

Individual provider Active NPI

Courtney Vann Blocker, FNP-C

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1134534399
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5017719 Issued in NC
Practice address
10710 Sikes PL Ste 100
Charlotte, NC 28277-8194
Phone
(704) 248-5101
Fax
(704) 248-5120
NPI assigned
Jun 26, 2014
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5017719 NC
Family Nurse Practitioner 363LF0000X SP018799 PA
Family Nurse Practitioner 363LF0000X 5017719 NC Primary
Diabetes Educator Registered Nurse 163WD0400X RN621420 PA

Addresses

Primary practice location

10710 Sikes PL Ste 100
Charlotte, NC 28277-8194

Mailing address

3158 Freedom Dr Ste 3102
Charlotte, NC 28208-0014
Phone (704) 971-7099

Other names 1

  • Courtney Vann Boksan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cblocker66436@direct.acumenmd.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180615002207 PA Practitioner - Nurse Practitioner 7911252960 Reassigns benefits to 2 organizations
I20230808001420 NC Practitioner - Nurse Practitioner 7911252960 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metrolina Nephrology Associates PAGroup PAC ID 8022916600, 85 clinicians
Complexcare Medical Group Midwest M PLLCGroup PAC ID 1355858630, 87 clinicians
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

7903 Providence Rd
Suite 110
Charlotte, NC 28277-9763
Phone (704) 248-5101

969 Cox Rd
Gastonia, NC 28054-3455
Phone (704) 866-8596

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN621420PAMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Metrolina Nephrology Associates, PA CurrentSince Jan 8, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Oct 14, 2019 Accepting new patients
Pinnacle Health Medical Services CurrentSince May 8, 2018 Accepting new patients
Complexcare Medical Group Midwest M PLLC Nurse Practitioner CurrentSince May 31, 2025 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Dec 7, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Oct 14, 2019 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services CurrentSince May 8, 2018 Accepting new patients
Theoria Medical Nurse Practitioner Past Accepting new patients
Charlotte Radiology P a PastSince Dec 1, 2023 Accepting new patients

Locations

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

2711 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 342-1900

3158 Freedom Dr
Ste 3101
Charlotte, NC 28208

3158 Freedom Dr
Ste 3102
Charlotte, NC 28208
Phone (704) 731-6857

7903 Providence Rd
Ste 110
Charlotte, NC 28277
Phone (704) 248-5101

2544 Court Dr
Ste F
Gastonia, NC 28054
Phone (704) 864-8302

969 Cox Rd
Gastonia, NC 28054
Phone (704) 266-8596

10506 Clear Creek Commerce Dr
Mint Hill, NC 28227
Phone (704) 545-2377

430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

900 Bryan St
Ste 4
Huntingdon, PA 16652
Phone (814) 643-8424

2005 Technology Pkwy
Ste 440
Mechanicsburg, PA 17050
Phone (717) 614-4420

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

292 Saint Charles Way
York, PA 17402
Phone (717) 851-6231

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: cblocker2953616@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: cblocker66436@direct.acumenmd.com

Organizations & group practices 11

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1134534399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 FREEDOM DR STE 3102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282080014",
            "telephone_number": "704-971-7099",
            "fax_number": "704-971-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 SIKES PL STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778194",
            "telephone_number": "704-248-5101",
            "fax_number": "704-248-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCKER",
        "first_name": "COURTNEY",
        "middle_name": "VANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5017719",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018799",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5017719",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "PA",
            "license": "RN621420",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cblocker66436@direct.acumenmd.com",
            "affiliation": "N",
            "endpointDescription": "Acumen Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CED",
            "address_1": "10710 Sikes Pl Ste 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282778194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "BOKSAN",
            "middle_name": "VANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.