David Richard Courtemanche, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

102629 Issued in NC

Practice address

3734 Reynolda Rd
Winston Salem, NC 27106-2240

Phone

(336) 922-1102

Fax

(336) 922-5012

NPI assigned

Feb 5, 2007

Last updated

May 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• General Medical Clinic, PA

  • Primary Care Clinic/Center
  • Greensboro, NC
  • NPI 1871522003
  Medicare reassignment
• Cardinal Health Services, PC

  • Geriatric Medicine (Family Medicine) Physician
  • Winston Salem, NC
  • NPI 1144575929
  NPD (past)
• Carolina Medicorp Enterprises, Inc

  dba Prime Care of Greensboro

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1154389088

  Physician Assistant

  NPD (past)
• Oldtown Immediate Care, PA

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1194060368
  NPD (past)
• R E Williford MD PA

  • Family Medicine Physician
  • Asheboro, NC
  • NPI 1942320312
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1285772798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3069 TRENWEST DR",
            "address_2": "STE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033211",
            "telephone_number": "336-922-1102",
            "fax_number": "336-922-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 REYNOLDA RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271062240",
            "telephone_number": "336-922-1102",
            "fax_number": "336-922-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTEMANCHE",
        "first_name": "DAVID",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "153YJ",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102968",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Chirstopher Council Jr.
• Chase Countryman
• County of Forsyth, North Carolina (Forsyth County Pharmacy)
• County of Forsyth, North Carolina (Forsyth County North Carolina)
• Chad David Courtemanche, M.D.
• Rachel Marie Courtemanche, P.A.
• Ray Donskey Courtney III, RPH
• Tinesha Chevon Couthen
• Daniel Edward Couture, MD
• Marion Margaret Couzens, DO

• Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.