Individual provider Active NPI

Courtney Wharton

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1306255393
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05124 Issued in NC
Practice address
1210 New Garden Rd
Greensboro, NC 27410-2721
Phone
(336) 294-6190
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-05124 NC Primary

Addresses

Primary practice location

1210 New Garden Rd
Greensboro, NC 27410-2721

Mailing address

1210 New Garden Rd
Greensboro, NC 27410-2721

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address courtney.wharton@eaglep.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141204001412 NC Practitioner - Physician Assistant 7214158906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagle Physicians and Associates PAGroup PAC ID 0244134468, 101 clinicians

Practice addresses (Care Compare)

1210 New Garden Rd
Greensboro, NC 27410-2721
Phone (336) 294-6190

301 E Wendover Ave
Suite 215
Greensboro, NC 27401-1207
Phone (336) 379-1156

301 E Wendover Ave
Suite 300
Greenboro, NC 27401-1231
Phone (336) 268-3380

5701 W Friendly Aveneue
Greensboro, NC 27410-4112
Phone (336) 274-6515

5921 W Friendly Ave
Greensboro, NC 27410-3268

Hospital & facility affiliations

  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Physicians and Associates PA CurrentSince Aug 25, 2014 Accepting new patients
Eagle Physicians and Associates PA Physician Assistant CurrentSince Aug 25, 2014 Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients

Locations

5921 W Friendly Ave
Ste D
Greensboro, NC 27410
Phone (336) 218-8490

324 W Wendover Ave
Ste 200
Greensboro, NC 27408
Phone (336) 274-6515

Organizations & group practices 5

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 1

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": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1306255393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 NEW GARDEN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 NEW GARDEN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102721",
            "telephone_number": "336-294-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHARTON",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "courtney.wharton@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1210 New Garden Rd",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274102721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.