Courtney Shae Gibson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10024300-APRN Issued in OR

Practice address

364 SE 8TH Ave Ste 108a
Hillsboro, OR 97123-4253

Phone

(503) 640-3687

Fax

(503) 640-3688

NPI assigned

Jul 5, 2019

Last updated

Jun 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Tuality Medical Group LLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1073929782
  Medicare reassignment NPD
• Tuality Healthcare

  dba THC Based Physicians

  • General Acute Care Hospital
  • Hillsboro, OR
  • NPI 1336228659
  NPD
• Tuality Medical Group LLC

  dba Hillsboro Medical Center Neurology Clinic

  • Neurology Physician
  • Hillsboro, OR
  • NPI 1639690704
  NPD

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1689236077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 SE 8TH AVE STE 108A",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234253",
            "telephone_number": "503-640-3687",
            "fax_number": "503-640-3688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2410 Round Rock Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786814019",
            "country_code": "US",
            "telephone_number": "512-341-8724",
            "fax_number": "512-687-0295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "COURTNEY",
        "middle_name": "SHAE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP141935",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "092344-23",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10024300-APRN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401436702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401436703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samira Ghorbani, DMD
• Ayesha Shabir Ghoto
• Renata Giacomini, MA
• Gerald E Gibbs, M.D.
• Chelsea Nicole Gibson
• Hanna Gietzen, PA-C
• Jonathan William Gietzen, PA-C
• Delasnieves Gil Barrios
• Aaron Michael Gilbert
• Lisa Michele Lazo Gilbert, M.D.

• Family Nurse Practitioner in Hillsboro, OR
• Providers in Hillsboro, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.