Courtney Rae Criswell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111862 Issued in FL

Practice address

5191 First Coast Tech Pkwy FL 3
Jacksonville, FL 32224-0609

Phone

(904) 223-3321

Fax

(904) 223-2169

NPI assigned

Feb 28, 2019

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 names 1

• Courtney R Davis Former name

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Spine Center PAGroup PAC ID 6901890300, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score

80.97 of 100Reported as group

Quality

70.19

Promoting interoperability

98

Improvement activities

40

Cost

68.04

Merit-based Incentive Payment System (MIPS)

Final score

81.8 of 100Reported as group

Quality

77.71

Promoting interoperability

95

Improvement activities

40

Cost

65.81

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: courtney.criswell@jspc.eclinicaldirectplus.com

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.

• Jacksonville Spine Center PA

  • Pain Medicine (Anesthesiology) Physician
  • Jacksonville, FL
  • NPI 1881643757
  Medicare reassignment Care Compare group NPD
• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Brunswick, GA
  • NPI 1902852130
  Medicare reassignment NPD
• Jacksonville Spine Center PA

  • Interventional Pain Medicine Physician
  • Altamonte Springs, FL
  • NPI 1861197071
  NPD
• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Savannah, GA
  • NPI 1942052022
  NPD
• Georgia Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Waycross, GA
  • NPI 1134769714
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1376114413

  Inpatient rehabilitation facility

  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1912947748

  Inpatient rehabilitation facility

  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1629535307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3408 Trout St",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315203622",
            "country_code": "US",
            "telephone_number": "912-466-9111",
            "fax_number": "912-466-0366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISWELL",
        "first_name": "COURTNEY",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111862",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "DAVIS",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jody Vicencio Crisostomo, PAC
• Claire Elaine Criss
• Jason D Criss, PT
• Margaret Crist
• Jessica Cristobal Diaz
• Joanne G. Criswell
• Kimberly Robin Critelli, M.S., CCC-SLP
• Robin E Criter, AUD
• Critical Care of N Jacksonville, PA
• Andre Critsinelis, MD

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

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

Verify at the official NPI Registry.