Individual provider Active NPI

Courtney Scott

  • Nurse Practitioner
  • Sewell, NJ
National Provider Identifier
1356989321
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01001600 Issued in NJ
Practice address
900 Medical Center Dr Ste 200
Sewell, NJ 08080-2358
Phone
(856) 557-7900
NPI assigned
Dec 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ01001600 NJ Primary

Addresses

Primary practice location

900 Medical Center Dr Ste 200
Sewell, NJ 08080-2358

Mailing address

900 Medical Center Dr Ste 200
Sewell, NJ 08080-2358

Other identifiers 1

IdentifierTypeStateIssuer
0715590MedicaidNH

Other names 1

  • Courtney Daniels Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20200309000788 NJ Practitioner - Nurse Practitioner 5890123756 Reassigns benefits to 1 organization
I20240705001561 PA Practitioner - Nurse Practitioner 5890123756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Jefferson Medical College of Thomas Jefferson University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1101 Chestnut St
Philadelphia, PA 19107-3619
Phone (800) 533-3669

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01001600NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice P.C. CurrentSince Feb 24, 2020 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Feb 24, 2020 Accepting new patients
Jefferson University Physicians CurrentSince Jun 2, 2024 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Jun 15, 2021 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

2211 Chapel Ave W
Ste 303
Cherry Hill, NJ 08002
Phone (856) 566-5478

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

900 Medical Center Dr
Ste 200
Sewell, NJ 08080
Phone (856) 557-7900

1101 Chestnut St
Philadelphia, PA 19107
Phone (215) 955-6760

1101 Chestnut St
Fl 14
Philadelphia, PA 19107
Phone (215) 955-8084

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

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": "1576800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1356989321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MEDICAL CENTER DR STE 200",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MEDICAL CENTER DR STE 200",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802358",
            "telephone_number": "856-557-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-20",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01001600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0715590",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "DANIELS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.