Individual provider Active NPI

Courtney Carter, CRNP

  • Adult Health Nurse Practitioner
  • Selma, AL
National Provider Identifier
1407306624
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1-100214 Issued in AL
Practice address
1023 Medical Center Pkwy
Suite 401
Selma, AL 36701-6750
Phone
(334) 875-7173
Fax
(334) 875-7925
NPI assigned
Oct 12, 2016
Last updated
Dec 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-100214 AL Primary
Gerontology Nurse Practitioner 363LG0600X 1-100214 AL
Primary Care Nurse Practitioner 363LP2300X 1-100214 AL
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 1-100214 AL
Registered Nurse 163W00000X 1-100214 AL

Addresses

Primary practice location

1023 Medical Center Pkwy
Suite 401
Selma, AL 36701-6750

Mailing address

1023 Medical Center Pkwy
Suite 401
Selma, AL 36701-6750
Phone (334) 875-7173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180926000010 AL Practitioner - Nurse Practitioner 6709137078 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

108 Broad St
Selma, AL 36701-4639
Phone (334) 526-2887

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-100214ALMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vaughan Physician Practices LLC CurrentSince Aug 1, 2018 Accepting new patients
Queen City Women's Health Adult Health CurrentSince Jan 1, 2023 Accepting new patients
Vaughan Physician Practices LLC CurrentSince Aug 1, 2018 Accepting new patients
Vaughan Physician Practices, LLC Current Accepting new patients
Signify Health, LLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

1023 Medical Center Pkwy
Ste 305
Selma, AL 36701
Phone (334) 801-9952

1023 Medical Center Pkwy
Ste 401
Selma, AL 36701
Phone (334) 875-7173

108 Broad St
Selma, AL 36701
Phone (334) 505-0873

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: courtney.carter.1@26833.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19364/brand/1/csg/21/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1407306624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 MEDICAL CENTER PKWY",
            "address_2": "SUITE 401",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016750",
            "telephone_number": "334-875-7173",
            "fax_number": "334-875-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 MEDICAL CENTER PKWY",
            "address_2": "SUITE 401",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016750",
            "telephone_number": "334-875-7173",
            "fax_number": "334-875-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "COURTNEY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-100214",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "1-100214",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AL",
            "license": "1-100214",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "AL",
            "license": "1-100214",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-100214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, AL

Sources for this page

Verify at the official NPI Registry.