Individual provider Active NPI

Alyssa Courshon, AA

  • Critical Care Medicine (Anesthesiology) Physician
  • Atlanta, GA
National Provider Identifier
1255197117
Registry record updated Dec 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
PENDING Issued in GA
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322-8221
Phone
(404) 778-3482
NPI assigned
Feb 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X PENDING MO
Critical Care Medicine (Anesthesiology) Physician 207LC0200X PENDING GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322-8221

Mailing address

339 Consort Dr
Ballwin, MO 63011-4439
Phone (636) 386-9224

Other practice location 1

615 S New Ballas Rd Dept Of
Saint Louis, MO 63141-8221
Phone (636) 386-9224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240619002383 MO Practitioner - Anesthesiology Assistant 3577006436 Reassigns benefits to 1 organization
I20250402000064 GA Practitioner - Anesthesiology Assistant 3577006436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
PENDINGGAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Anesthesiology Associates, Inc. CurrentSince Jun 11, 2024 Accepting new patients
The Emory Clinic Inc CurrentSince Mar 13, 2025 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

339 Consort Dr
Ballwin, MO 63011
Phone (636) 386-7222

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

Interoperability endpoints

  • Direct secure messaging: acourshon1042474@direct.emory.org

Organizations & group practices 3

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 3

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": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734134400000",
    "number": "1255197117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "636-386-9224",
            "fax_number": "636-386-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303228221",
            "telephone_number": "404-778-3482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 S New Ballas Rd Dept Of",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418221",
            "country_code": "US",
            "telephone_number": "636-386-9224",
            "fax_number": "636-386-7679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COURSHON",
        "first_name": "ALYSSA",
        "name_prefix": "Ms.",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "GA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.