Individual provider Active NPI

Courtney Louise Dubose, CPNP-AC

  • Nurse Practitioner
  • Mt Pleasant, SC
National Provider Identifier
1225268592
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
19743 Issued in SC
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

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc Past Accepting new patients
Coastal Pediatric Associates, P.a. PastSince Apr 1, 2021 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.

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.

Verify at the official NPI Registry.