Courtney A Fussell, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5010598 Issued in NC

Practice address

115 E Gold St Ste 518
Kings Mountain, NC 28086-3431

Phone

(980) 404-0678

NPI assigned

May 21, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1568953099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 518",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280860518",
            "telephone_number": "980-404-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E GOLD ST STE 518",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280863431",
            "telephone_number": "980-404-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "COURTNEY",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "25902",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "87-3728031",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Essentially Living Inc
• Everette B Thombs, MD
• Karli Rachel Ford, LCMHCA
• Alexis Frisbee
• Mary Furstein, PHARM.D.
• Todd Gaddis
• Lance H Gaffney, DPT
• Paul Gregg Gambrell, CRNA
• Abdul Rashid Gangoo, MD
• Joshua Brian Garling, PHARMD

• Nurse Practitioner in Kings Mountain, NC
• Providers in Kings Mountain, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.