Individual provider Active NPI

Courtney Lavon Phillip, FNP-BC

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1205440328
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN967300 Issued in DC
Practice address
1350 Connecticut Ave NW Ste 1250
Washington, DC 20036-1728
Phone
(202) 627-1901
Fax
(415) 252-7176
NPI assigned
Sep 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R157014 MD
Family Nurse Practitioner 363LF0000X RN967300 DC Primary

Addresses

Primary practice location

1350 Connecticut Ave NW Ste 1250
Washington, DC 20036-1728

Mailing address

4461 Pleasant Hill CT
Pomfret, MD 20675-3104
Phone (202) 528-0971

Other practice location 1

4461 Pleasant Hill Ct
Pomfret, MD 20675-3104
Phone (202) 528-0971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20210609003117 DC Practitioner - Nurse Practitioner 9234539578 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
True North Health Navigation LLC CurrentSince Sep 1, 2022 Accepting new patients
Dispatchhealth NV Wagner PC Past Accepting new patients
True North Health Navigation LLC Past Accepting new patients
Premier Health Express and Advanced Diagnostics Inc PastSince Apr 7, 2021 Accepting new patients

Locations

3825 N Lafayette St
Denver, CO 80205
Phone (303) 505-1518

8000 Westpark Dr
Ste 130
Mc Lean, VA 22102
Phone (702) 848-4443

1951 Kidwell Dr
Ste 101
Vienna, VA 22182
Phone (571) 348-4721

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1205440328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 PLEASANT HILL CT",
            "city": "POMFRET",
            "state": "MD",
            "postal_code": "206753104",
            "telephone_number": "202-528-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CONNECTICUT AVE NW STE 1250",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200361728",
            "telephone_number": "202-627-1901",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4461 Pleasant Hill Ct",
            "address_purpose": "LOCATION",
            "city": "Pomfret",
            "state": "MD",
            "postal_code": "206753104",
            "country_code": "US",
            "telephone_number": "202-528-0971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIP",
        "first_name": "COURTNEY",
        "middle_name": "LAVON",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R157014",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN967300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.