Individual provider Active NPI

Courtney St Clair

  • Gerontology Nurse Practitioner
  • Ashland, OH
National Provider Identifier
1508575168
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN.CNP.0041820 Issued in OH
Practice address
1251 E Main St
Ashland, OH 44805-2810
Phone
(731) 394-1145
NPI assigned
Nov 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.0041820 OH Primary

Addresses

Primary practice location

1251 E Main St
Ashland, OH 44805-2810

Mailing address

PO Box 269084
Dept 1102
Oklahoma City, OK 73126
Phone (731) 394-1145

Other practice location 1

1700 E Smithville Western Rd
Wooster, OH 44691-1010
Phone (330) 601-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20260406002253 OH Practitioner - Nurse Practitioner 9830664051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

1251 E Main St
Ashland, OH 44805-2810
Phone (731) 394-1145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0041820OHMDGerontology Nurse Practitioner

Organizations & group practices 2

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": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1508575168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269084",
            "address_2": "DEPT 1102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73126",
            "telephone_number": "731-394-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 E MAIN ST",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448052810",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 E Smithville Western Rd",
            "address_purpose": "LOCATION",
            "city": "Wooster",
            "state": "OH",
            "postal_code": "446911010",
            "country_code": "US",
            "telephone_number": "330-601-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST CLAIR",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-22",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.0041820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OH

Sources for this page

Verify at the official NPI Registry.