Courtney Anne Strubin

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11453 Issued in NC

Practice address

3071 Southport Supply Rd SE
Bolivia, NC 28422-7943

Phone

(910) 933-2408

NPI assigned

Jun 19, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: courtney.strubin.1@20427.direct.athenahealth.com

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1629638713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 SOUTHPORT SUPPLY RD SE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284227943",
            "telephone_number": "910-933-2408",
            "fax_number": "910-814-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 SOUTHPORT SUPPLY RD SE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284227943",
            "telephone_number": "910-933-2408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1851 MacGregor Downs Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278345925",
            "country_code": "US",
            "telephone_number": "910-814-4191",
            "fax_number": "910-814-4198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STRUBIN",
        "first_name": "COURTNEY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Edwards Smith, OBNP
• Southport Speech and Language, PLLC
• Abigail Rose Squires, FNP-BC
• Shea Elisabeth Stewart, CNM
• Heather Locklear Strickland, MA,LCMHCS, LCAS
• Sunset Harbor Psychiatric Services, PLLC
• Hayley Elizabeth Swatzel, PA-C
• Elisa Margaret Thomas, MA, LMFT
• Richard Shaw Thompson, DO
• Mark Tillotson, M.D.

• General Practice Dentistry in Bolivia, NC
• Providers in Bolivia, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.