Courtney S Dubose, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

893316 Issued in MS

Practice address

1061 Highway 35 S
Forest, MS 39074-4000

Phone

(601) 541-4313

NPI assigned

Sep 1, 2020

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22967/brand/1/csg/1/fhir/r4

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.

• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family, MS

  Medicare reassignment Care Compare group NPD
• East Mississippi Medical Clinic, PLLC

  • Clinic/Center
  • Meridian, MS
  • NPI 1881640142

  MS

  Medicare reassignment NPD
• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  MS

  Medicare reassignment NPD
• Medical Services of Meridian, Inc.

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1174095988

  MS

  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  MS

  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  Care Compare group NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Mountain Home, AR
  • NPI 1972262400
  Care Compare group
• Fast Pace Mississippi, PLLC

  • Urgent Care Clinic/Center
  • Greenbriar, AR
  • NPI 1982361259
  Care Compare group
• East Mississippi Medical Clinic

  • Primary Care Clinic/Center
  • Newton, MS
  • NPI 1497096036
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1134733728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HIGHWAY 35 S",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390744000",
            "telephone_number": "601-541-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HIGHWAY 35 S",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390744000",
            "telephone_number": "601-541-4313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8252 Lizelia Rd",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393058511",
            "country_code": "US",
            "telephone_number": "601-678-6609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "COURTNEY",
        "middle_name": "S",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2021-06-28",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "893316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1P7544",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Courtney.dubose@fastpacemedical.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1061 Highway 35 S",
            "city": "Forest",
            "state": "MS",
            "country_code": "US",
            "postal_code": "390744000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nancy G Culliver, SLP
• Temeka Denson, LPN, CCMA,
• Rhuel Dickinson III, DPT
• Divine Transit, LLC
• Drayer Physical Therapy Mississippi LLC
• Dura-Quip Medical Equipment Inc.
• Angelia Dykeman, SLP
• Eady Chiropractic, P.a.
• Buddy Lee Eady, D.C.
• Randy Dawayne Eason, O.D.

• All providers in Forest, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.