Individual provider Active NPI

Courtney Nicole Gleason, M.D.

  • Pediatric Sports Medicine Physician
  • Atlanta, GA
National Provider Identifier
1154585438
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
74734 Issued in GA
Practice address
1968 Hawks LN NE Ste 200
Atlanta, GA 30329-2283
Phone
(404) 778-4398
Fax
(404) 778-7170
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X TRN13066 FL
Pediatric Sports Medicine Physician 2080S0010X 74734 GA Primary

Addresses

Primary practice location

1968 Hawks LN NE Ste 200
Atlanta, GA 30329-2283

Mailing address

1968 Hawks LN NE Ste 200
Atlanta, GA 30329-2283
Phone (404) 778-4398

Other practice location 1

59 Executive Park S
Atlanta, GA 30329-2208
Phone (404) 778-4398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20170124000809 GA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 2365724556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of South Carolina School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

5513 Chamblee Dunwoody Rd
Suite 430
Dunwoody, GA 30338-4106
Phone (770) 551-9633

Hospital & facility affiliations

  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010
  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN13066FLMDOrthopaedic Surgery Physician
74734GAMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Jan 30, 2017 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Emory Health Care Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

59 Executive Park South NE
Atlanta, GA 30329
Phone (404) 778-6330

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: cgleason27750@direct.emory.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154585438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1968 HAWKS LN NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292283",
            "telephone_number": "404-778-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 HAWKS LN NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292283",
            "telephone_number": "404-778-4398",
            "fax_number": "404-778-7170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "59 Executive Park S",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303292208",
            "country_code": "US",
            "telephone_number": "404-778-4398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "COURTNEY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2022-07-21",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "TRN13066",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "GA",
            "license": "74734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.