Active NPI
Courtney Louise Dubose, CPNP-AC
- Nurse Practitioner
- Mt Pleasant, SC
National Provider Identifier
1225268592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 19743
- Practice address
- 1952 Long Grove Dr
Mt Pleasant, SC 29464-7579 - Phone
- (843) 971-2992
- NPI assigned
- Jul 21, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 19743 | SC | Primary |
Addresses
Primary practice location
1952 Long Grove Dr
Mt Pleasant, SC 29464-7579
Mailing address
2051 Charlie Hall Blvd
Charleston, SC 29414-5834
Phone (843) 737-9467
Other practice location 1
9165 University Blvd Ste 100
North Charleston, SC 29406-7133
Phone (843) 284-4255
Other practice location 2
776 Daniel Ellis Dr Ste A
Charleston, SC 29412-3094
Phone (843) 795-8100
Other practice location 3
2051 Charlie Hall Blvd
Charleston, SC 29414-5834
Phone (843) 573-2535
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Family Care, Inc | Past | Accepting new patients | |
| Coastal Pediatric Associates, P.a. | Past | Accepting new patients |
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.
-
- Pediatrics Physician
- Charleston, SC
- NPI 1750318101
-
- Pediatrics Physician
- Charleston, SC
- NPI 1770700759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1225268592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2051 CHARLIE HALL BLVD",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294145834",
"telephone_number": "843-737-9467",
"fax_number": "843-371-5507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1952 LONG GROVE DR",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "294647579",
"telephone_number": "843-971-2992"
}
],
"practiceLocations": [
{
"address_1": "9165 University Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "North Charleston",
"state": "SC",
"postal_code": "294067133",
"country_code": "US",
"telephone_number": "843-284-4255",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "776 Daniel Ellis Dr Ste A",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294123094",
"country_code": "US",
"telephone_number": "843-795-8100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2051 Charlie Hall Blvd",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294145834",
"country_code": "US",
"telephone_number": "843-573-2535",
"fax_number": "843-573-2534",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUBOSE",
"first_name": "COURTNEY",
"middle_name": "LOUISE",
"name_prefix": "Mrs.",
"credential": "CPNP-AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "19743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mt Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.