Active NPI
Courtney McConnell, PA-C
- Physician Assistant
- Las Vegas, NV
National Provider Identifier
1497476048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2789
- Practice address
- 2625 Box Canyon Dr
Las Vegas, NV 89128-0450 - Phone
- (702) 360-6100
- Fax
- (702) 360-8096
- NPI assigned
- Sep 12, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2789 | NV | Primary |
Addresses
Primary practice location
2625 Box Canyon Dr
Las Vegas, NV 89128-0450
Mailing address
2625 Box Canyon Dr
Las Vegas, NV 89128-0450
Phone (702) 360-6100
Other names 1
- Courtney Smith
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2625 Box Canyon Dr
Las Vegas, NV 89128-0450
Phone (702) 360-6100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
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.
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- Allergy & Immunology Physician
- Las Vegas, NV
- NPI 1285807537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730160000000",
"number": "1497476048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 BOX CANYON DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280450",
"telephone_number": "702-360-6100",
"fax_number": "702-360-8096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 BOX CANYON DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280450",
"telephone_number": "702-360-6100",
"fax_number": "702-360-8096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "COURTNEY",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-12",
"last_updated": "2024-10-29",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA2789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "COURTNEY",
"last_name": "SMITH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.