Individual provider Active NPI

Courtney Sharee Page, RC 72216

  • Prosthetics Case Management
  • Columbia, SC
National Provider Identifier
1265179808
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
72216 Issued in SC
Practice address
9320 Two Notch Rd Ste a
Columbia, SC 29223-6402
Phone
(803) 238-6608
NPI assigned
May 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X 72216 SC Primary

Addresses

Primary practice location

9320 Two Notch Rd Ste a
Columbia, SC 29223-6402

Mailing address

6625 Valleybrook Rd
Columbia, SC 29206-1052
Phone (803) 238-6608

Other identifiers 1

IdentifierTypeStateIssuer
800541897MedicaidSC

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

State licenses

LicenseStateTypeSpecialty
72216SCMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1265179808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 VALLEYBROOK RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292061052",
            "telephone_number": "803-238-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 TWO NOTCH RD STE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236402",
            "telephone_number": "803-238-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "COURTNEY",
        "middle_name": "SHAREE",
        "name_prefix": "Ms.",
        "credential": "RC 72216",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "SC",
            "license": "72216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800541897",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.