Individual provider Active NPI

Courtney Kelsey, RN

  • Acute Care Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1184592958
Registry record updated Jan 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
CNP261052 Issued in ME
Practice address
489 State St
Bangor, ME 04401-6616
Phone
(207) 973-7000
NPI assigned
Oct 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN84115 ME
Acute Care Nurse Practitioner 363LA2100X CNP261052 ME Primary

Addresses

Primary practice location

489 State St
Bangor, ME 04401-6616

Mailing address

489 State St
Bangor, ME 04401-6616

Other names 1

  • Courtney H Gross Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260310004764 ME Practitioner - Nurse Practitioner 2163905902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Hospital & facility affiliations

  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN84115MEMDCritical Care Medicine Registered Nurse
CNP261052MEMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Mar 16, 2026 Accepting new patients
Eastern Maine Medical Center CurrentSince Mar 16, 2026 Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

Organizations & group practices 2

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 1

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": "1761264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768608000000",
    "number": "1184592958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "COURTNEY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-24",
        "last_updated": "2026-01-17",
        "certification_date": "2026-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "ME",
            "license": "RN84115",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ME",
            "license": "CNP261052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "GROSS",
            "middle_name": "H",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.