Individual provider Active NPI

Courtney Elizabeth De Jesso, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Ashland, KY
National Provider Identifier
1427194232
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
50656 Issued in KY
Practice address
2201 Lexington Ave
Ashland, KY 41101-2843
Phone
(606) 408-4000
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X Q2987 TX
Neonatal-Perinatal Medicine Physician 2080N0001X TP079 KY
Neonatal-Perinatal Medicine Physician 2080N0001X 50656 KY Primary

Addresses

Primary practice location

2201 Lexington Ave
Ashland, KY 41101-2843

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other names 1

  • Courtney Elizabeth Russell Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cdejesso64734@direct.kdhealth.us Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170919004369 KY Practitioner - Pediatric Medicine 3870712839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50656KYMDNeonatal-Perinatal Medicine Physician
TP079KYMDNeonatal-Perinatal Medicine Physician
Q2987TXMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc CurrentSince Sep 1, 2017 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Sep 1, 2017 Accepting new patients
Ashland Hospital Corporation Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

Interoperability endpoints

  • Direct secure messaging: cdejesso64734@direct.kdhealth.us

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1427194232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843",
            "telephone_number": "606-408-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESSO",
        "first_name": "COURTNEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "Q2987",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "TP079",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "50656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdejesso64734@direct.kdhealth.us",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "TXT",
            "address_1": "2201 Lexington Ave",
            "city": "Ashland",
            "state": "KY",
            "country_code": "US",
            "postal_code": "411012843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "RUSSELL",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.