Individual provider Active NPI

Courtney Prim, PA-C

  • Physician Assistant
  • North Wilkesboro, NC
National Provider Identifier
1497359707
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10727 Issued in NC
Practice address
1103 W D St
North Wilkesboro, NC 28659-4141
Phone
(336) 883-0029
Fax
(336) 863-1938
NPI assigned
Nov 27, 2020
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 0010-10727 NC
Physician Assistant 363A00000X 0010-10727 NC Primary

Addresses

Primary practice location

1103 W D St
North Wilkesboro, NC 28659-4141

Mailing address

645 N Main St
High Point, NC 27260-5017
Phone (336) 883-0029

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
I20201210001200 NC Practitioner - Physician Assistant 0042622367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bethany Medical CenterGroup PAC ID 4486614575, 71 clinicians

Practice addresses (Care Compare)

1103 W D St
North Wilkesboro, NC 28659-4141
Phone (336) 883-0029

495 Arbor Hill Rd
Kernersville, NC 27284-3335
Phone (336) 883-0029

507 N Lindsay St
High Point, NC 27262-4303
Phone (336) 883-0029

Merit-based Incentive Payment System (MIPS)

Final score
88.84 of 100Reported as group
Quality
70.27
Promoting interoperability
98
Improvement activities
40
Cost
77.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-10727NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bethany Medical Center, PA Past Accepting new patients
Bethany Medical Center PastSince Nov 1, 2020 Accepting new patients
Bethany Medical Center Past Accepting new patients
Bethany Medical Center PA Past Accepting new patients
Bethany Medical Center Pain Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: courtneyprim@bethanymed.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1606435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1497359707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MAIN ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272605017",
            "telephone_number": "336-883-0029",
            "fax_number": "336-883-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 W D ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594141",
            "telephone_number": "336-883-0029",
            "fax_number": "336-863-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIM",
        "first_name": "COURTNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-27",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "0010-10727",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

Verify at the official NPI Registry.