Individual provider Active NPI

Courtney McLendon, CPNP

  • Pediatric Nurse Practitioner
  • North Augusta, SC
National Provider Identifier
1144643941
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN.18369 APRN Issued in SC
Practice address
140 Allen Court
North Augusta, SC 29860
Phone
(803) 510-0007
Fax
(803) 510-0144
NPI assigned
Jan 29, 2014
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN.18369 APRN SC Primary

Addresses

Primary practice location

140 Allen Court
North Augusta, SC 29860

Mailing address

140 Allen Court
North Augusta, SC 29860
Phone (803) 510-0007

Other identifiers 1

IdentifierTypeStateIssuer
NP2711MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.18369 APRNSCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Augusta Pediatrics LLC CurrentSince Feb 18, 2024 Accepting new patients
Liberty Doctors, LLC PastSince Dec 1, 2021 Accepting new patients
Liberty Doctors, LLC PastSince Dec 1, 2021 Accepting new patients
North Augusta Pediatrics LLC PastSince Feb 18, 2024 Accepting new patients

Locations

140 Allen Ct
North Augusta, SC 29860
Phone (803) 510-0007

Interoperability endpoints

  • Direct secure messaging: cmclendon@libertydoctors.ssdirect.aprima.com
  • Direct secure messaging: cmclendon@tiffanypeds.gwaydirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1144643941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ALLEN COURT",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "29860",
            "telephone_number": "803-510-0007",
            "fax_number": "803-510-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ALLEN COURT",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "29860",
            "telephone_number": "803-510-0007",
            "fax_number": "803-510-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLENDON",
        "first_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-29",
        "last_updated": "2024-02-14",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "APN.18369 APRN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2711",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Augusta, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.