Individual provider Active NPI

Marc Vincent Courts, M.D.

  • Pediatrics Physician
  • Loudon, TN
National Provider Identifier
1609086214
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
43430 Issued in TN
Practice address
616 Ward Ave
Loudon, TN 37774-1323
Phone
(865) 458-5666
Fax
(865) 458-9906
NPI assigned
May 23, 2007
Last updated
Mar 29, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 43430 TN
Pediatrics Physician 208000000X 43430 TN Primary

Addresses

Primary practice location

616 Ward Ave
Loudon, TN 37774-1323

Mailing address

616 Ward Ave
Loudon, TN 37774-1323
Phone (865) 458-5666

Other identifiers 1

IdentifierTypeStateIssuer
1503975MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230210001404 TN Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 9234501685 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43430TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Pediatric Emergency Medicine CurrentSince Nov 8, 2022 Accepting new patients
Loudon Pediatric Clinic PC Pediatrics Past Accepting new patients

Locations

2018 Clinch Ave
Knoxville, TN 37916
Phone (865) 541-8000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

Interoperability endpoints

  • Direct secure messaging: jguider@lpc.opdirect.net
  • Direct secure messaging: mcourts@lpc.opdirect.net

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, 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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1609086214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 WARD AVE",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377741323",
            "telephone_number": "865-458-5666",
            "fax_number": "865-458-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 WARD AVE",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377741323",
            "telephone_number": "865-458-5666",
            "fax_number": "865-458-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTS",
        "first_name": "MARC",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "43430",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "43430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1503975",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loudon, TN

Sources for this page

Verify at the official NPI Registry.