Courtney Marie Lee, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

178921 Issued in AK

Practice address

1650 Cowles St
Fairbanks, AK 99701-5907

Phone

(907) 458-6450

Fax

(907) 458-6430

NPI assigned

Oct 11, 2006

Last updated

Jun 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Courtney Marie Koehnen Former name

Medicare fee-for-service enrollment

Enrolled in TX, AK2 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

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairbanks Memorial Cardiology Center LLCGroup PAC ID 0244511269, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: courtney.lee.p1@direct.porterheart.nextgenshare.com

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.

• Fairbanks Memorial Cardiology Center, LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1386193472
  Medicare reassignment Care Compare group
• Tanana Chiefs Conference

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1821201278

  TX

  Medicare reassignment
• Tanana Chiefs Conference

  • Ambulatory Surgical Clinic/Center
  • Fairbanks, AK
  • NPI 1871332387
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  Care Compare affiliation

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1417046459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015907",
            "telephone_number": "907-458-6450",
            "fax_number": "907-458-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015907",
            "telephone_number": "907-458-6450",
            "fax_number": "907-458-6430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5955 Zeamer Ave",
            "address_2": "673d MDOS/SGOE",
            "address_purpose": "LOCATION",
            "city": "Jber",
            "state": "AK",
            "postal_code": "995063702",
            "country_code": "US",
            "telephone_number": "907-580-5550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044518",
            "country_code": "US",
            "telephone_number": "952-992-5290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "178921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1755878",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "KOEHNEN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy Ledna, NCC
• Laverne J Lee Huus
• Felicity Lee Sankoh
• Fanta Lee-Sankoh, BA, SW
• Bre'Asia Keianna Lee
• Duxie Ellington Lee Jr.
• Esther Lee, PHARM.D
• Kaitlyn Taylor Lee
• Margaret H Lee, DDS
• Minh Kevin Lee, DDS

• Physician Assistant in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.