Individual provider Active NPI

Courtney Jane Luedtke, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1184905754
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118264 Issued in FL
Practice address
1301 Palm Ave Ste 100
Jacksonville, FL 32207-8457
Phone
(904) 202-7300
Fax
(904) 202-2754
NPI assigned
Sep 8, 2011
Last updated
Jan 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-03081 NC
Physician Assistant 363A00000X PA9118264 FL Primary
Physician Assistant 363A00000X 0010-03081 NC

Addresses

Primary practice location

1301 Palm Ave Ste 100
Jacksonville, FL 32207-8457

Mailing address

PO Box 746654
Atlanta, GA 30374-6654
Phone (904) 202-2092

Other practice location 1

14546 Old Saint Augustine Rd Ste 104
Jacksonville, FL 32258-5469
Phone (904) 271-6890

Other names 1

  • Ms. Courtney Jane Smith Meyer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240515004576 FL Practitioner - Physician Assistant 1254506959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist MD Anderson Cancer Physicians IncGroup PAC ID 5991932063, 115 clinicians

Practice addresses (Care Compare)

1301 Palm Ave
Jacksonville, FL 32207-8432
Phone (904) 202-7300

14546 Old Saint Augustine Rd
Jacksonville, FL 32258-5469
Phone (904) 202-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-03081NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Aug 24, 2014 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 24, 2014 Accepting new patients
Baptist MD Anderson Cancer Physicians Inc CurrentSince Apr 1, 2024 Accepting new patients
Baptist MD Anderson Cancer Physicians Inc Past Accepting new patients

Locations

1301 Palm Ave
Ste 100
Jacksonville, FL 32207

1301 Palm Ave
Ste 101
Jacksonville, FL 32207

16525 Holly Crest Ln
Ste 150
Huntersville, NC 28078
Phone (704) 384-1725

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

Interoperability endpoints

  • Direct secure messaging: csmith180132@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 5

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 2

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": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1184905754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746654",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746654",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PALM AVE STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078457",
            "telephone_number": "904-202-7300",
            "fax_number": "904-202-2754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14546 Old Saint Augustine Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322585469",
            "country_code": "US",
            "telephone_number": "904-271-6890",
            "fax_number": "904-202-2754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUEDTKE",
        "first_name": "COURTNEY",
        "middle_name": "JANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03081",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118264",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "MEYER",
            "middle_name": "JANE SMITH",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.