Courtney J Jack, APRN-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2020029102 Issued in MO

Practice address

400 SW Longview Blvd Ste 280
Lees Summit, MO 64081-2157

Phone

(816) 477-7200

NPI assigned

Nov 4, 2020

Last updated

Mar 21, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 9

Addresses

Other names 1

• Courtney J Perkins Former name

Medicare fee-for-service enrollment

Enrolled in KS, MO, IN, IA, WI, OH, MN, IL, NE9 enrollments

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 9

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Curana Health of Missouri-Kansas LLCGroup PAC ID 4789716531, 143 clinicians

CH Specialty Services Il PLLCGroup PAC ID 8224402482, 20 clinicians

Curana Health of Iowa PLLCGroup PAC ID 9133536113, 152 clinicians

Curana Health of Wisconsin IncGroup PAC ID 6204208754, 48 clinicians

Preferred Physician Services of Ohio LLCGroup PAC ID 7315328069, 66 clinicians

CH Specialty Services Mo LLCGroup PAC ID 0345614459, 108 clinicians

CH Specialty Services Ia PCGroup PAC ID 2466826102, 130 clinicians

Curana Health of Illinois PCGroup PAC ID 1456724434, 35 clinicians

CH Specialty Services KS LLCGroup PAC ID 6800261819, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• CH Specialty Services Mo LLC

  • Internal Medicine Physician
  • Lee's Summit, MO
  • NPI 1194422253
  Medicare reassignment Care Compare group NPD
• Curana Health of Missouri-Kansas LLC

  dba Elite Patient Care

  • Family Medicine Physician
  • Lee's Summit, MO
  • NPI 1306165337

  KS

  Medicare reassignment Care Compare group NPD
• CH Specialty Services Ia PC

  • Internal Medicine Physician
  • Osceola, IA
  • NPI 1942909353
  Medicare reassignment Care Compare group NPD
• CH Specialty Services Il PLLC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1922707702
  Medicare reassignment Care Compare group NPD
• CH Specialty Services KS LLC

  • Internal Medicine Physician
  • Lenexa, KS
  • NPI 1770282188
  Medicare reassignment Care Compare group NPD
• Curana Health of Illinois PC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1891400156
  Medicare reassignment Care Compare group NPD
• Curana Health of Iowa PLLC

  • Internal Medicine Physician
  • Osceola, IA
  • NPI 1730773714

  NE

  Medicare reassignment Care Compare group NPD
• Curana Health of Wisconsin Inc

  • Internal Medicine Physician
  • Hartford, WI
  • NPI 1699407890
  Medicare reassignment Care Compare group NPD
• Preferred Physician Services of Ohio LLC

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1538899638
  Medicare reassignment Care Compare group NPD
• CH Specialty Services MN PC

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1841999158
  Medicare reassignment NPD
• Curana Health of Minnesota PLLC

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1083365084

  Nurse Practitioner

  Medicare reassignment NPD
• Curana Health of Ohio

  • Internal Medicine Physician
  • Cincinnati, OH
  • NPI 1760114961
  Medicare reassignment NPD

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1336740620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 SW 30TH ST",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153381",
            "telephone_number": "816-718-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SW LONGVIEW BLVD STE 280",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812157",
            "telephone_number": "816-477-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "COURTNEY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.031610",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020029102",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "79693",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A181796",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0038214",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "16215-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71016015A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "12487",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "115898",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "PERKINS",
            "middle_name": "J",
            "credential": "APRN-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael George Ivancic, MD
• Ivna Pharmacy Services LLC (Stadium Pharmacy)
• Anusha Gopalakrishnan Iyer, M.B.B.S
• J and E Dental LLC (Summit Dental Studio)
• J O Johnson DO PC
• Jackson County Eye Clinic Inc. (Eyecare Associates of Lee's Summit)
• Julie Jackson, PHARMD
• Melanie L Jackson, MOTR/L, CHT
• Tammy J Jackson, LICENSED PSYCHOLOGIS
• Tiffany Jackson, LPC

• Family Nurse Practitioner in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.
• 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.