Individual provider Active NPI

Courtney Wance

  • Physician Assistant
  • Princeton, NJ
National Provider Identifier
1720835713
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
256 Bunn Dr Ste B
Princeton, NJ 08540-2859
Phone
(609) 454-0760
Fax
(609) 454-0761
NPI assigned
May 6, 2024
Last updated
May 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

256 Bunn Dr Ste B
Princeton, NJ 08540-2859

Mailing address

256 Bunn Dr Ste B
Princeton, NJ 08540-2859
Phone (609) 454-0760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20241112003189 NJ Practitioner - Physician Assistant 5597299685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton Spine and Joint CenterGroup PAC ID 4284793373, 7 clinicians

Practice addresses (Care Compare)

256 Bunn Dr
Suite B
Princeton, NJ 08540-2859
Phone (609) 454-0760

601 Ewing St
Suite A2
Princeton, NJ 08540-2767
Phone (609) 454-0760

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PSJC Associates PastSince Jul 31, 2022 Accepting new patients

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1720835713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 BUNN DR STE B",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402859",
            "telephone_number": "609-454-0760",
            "fax_number": "609-454-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 BUNN DR STE B",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402859",
            "telephone_number": "609-454-0760",
            "fax_number": "609-454-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANCE",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.