Courtney Gibson Nickels, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R865275 Issued in MS

Practice address

1207 Highway 182 W
Starkville, MS 39759-9820

Phone

(662) 320-7800

Fax

(662) 320-7797

NPI assigned

Jun 21, 2006

Last updated

May 20, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Anne Gibson Former name

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State Urgent Care, LLCGroup PAC ID 1557675311, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.92 of 100Reported as group

Quality

78.78

Improvement activities

40

Cost

78.02

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: courtney.nickels.1@11573.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/11573/brand/1/csg/1/fhir/r4

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.

• State Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Starkville, MS
  • NPI 1932587706
  Medicare reassignment Care Compare group NPD
• Getwell Urgent Care, LLC

  dba Getwell Urgent Care

  • Urgent Care Clinic/Center
  • Southaven, MS
  • NPI 1144639816
  Medicare reassignment NPD

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1508802208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164 MELROSE ST",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397599055",
            "telephone_number": "601-503-6912",
            "fax_number": "662-320-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 HIGHWAY 182 W",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397599820",
            "telephone_number": "662-320-7800",
            "fax_number": "662-320-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELS",
        "first_name": "COURTNEY",
        "middle_name": "GIBSON",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R865275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "GIBSON",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ms Eye Care PA (Mississippi Eye Care Starkville)
• Muddy Water Enterprises, LLC (Ford Vision Clinic)
• Murphy Medical Supply LLC
• Monique Murry
• Jaylin Neal
• Amelia Nolen, LCSW
• North Mississippi Allergy and Asthma Center PLLC (North Mississippi Allergy and Asthma Center of Starkville)
• North Mississippi Clinics LLC (Cardiology Associates of North MS Clinic)
• North Mississippi Hematology & Oncology Associates
• North Mississippi Medcial Center, Inc. (North Mississippi Cancer Care Starkville)

• Family Nurse Practitioner in Starkville, MS
• Providers in Starkville, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; 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.