Individual provider Active NPI

Courtney Martuscello Connolly, FNP

  • Family Nurse Practitioner
  • North Wilkesboro, NC
National Provider Identifier
1386301018
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5015385 Issued in NC
Practice address
1900 W Park Dr Ste B
North Wilkesboro, NC 28659-3563
Phone
(336) 903-6840
Fax
(336) 903-6841
NPI assigned
Nov 17, 2021
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5015385 NC Primary
Nurse Practitioner 363L00000X 5015385 NC

Addresses

Primary practice location

1900 W Park Dr Ste B
North Wilkesboro, NC 28659-3563

Mailing address

1900 W Park Dr Ste B
North Wilkesboro, NC 28659-3563
Phone (336) 903-6840

Other practice location 1

702 13th St
North Wilkesboro, NC 28659-4075
Phone (336) 990-9540

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
I20220215000642 NC Practitioner - Nurse Practitioner 9931592953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orchard Health Centers, PLLC.Group PAC ID 9638662927, 2 clinicians

Practice addresses (Care Compare)

702 13TH St
North Wilkesboro, NC 28659-4075
Phone (336) 990-9540

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5015385NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orchard Health Centers, PLLC Family CurrentSince Oct 21, 2025 Accepting new patients

Locations

702 13th St
North Wilkesboro, NC 28659
Phone (336) 667-5296

Organizations & group practices 1

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.

Hospital & facility affiliations 7

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": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1386301018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W PARK DR STE B",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593563",
            "telephone_number": "336-903-6840",
            "fax_number": "336-903-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W PARK DR STE B",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593563",
            "telephone_number": "336-903-6840",
            "fax_number": "336-903-6841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 13th St",
            "address_purpose": "LOCATION",
            "city": "North Wilkesboro",
            "state": "NC",
            "postal_code": "286594075",
            "country_code": "US",
            "telephone_number": "336-990-9540",
            "fax_number": "336-990-9542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "COURTNEY",
        "middle_name": "MARTUSCELLO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015385",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

Verify at the official NPI Registry.