Courtney Petersen, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME162748 Issued in FL

Practice address

655 W 8TH St
Jacksonville, FL 32209-6511

Phone

(904) 244-6340

Fax

(904) 244-5666

NPI assigned

Mar 22, 2021

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

Enrolled in FL

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

Specialty

Emergency Medicine

Education

University of South Carolina School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, shared by 5 NPIs, 908 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpetersen725234@direct.shands.ufl.edu
• Direct secure messaging: cpetersen2082928@direct.trinity-health.org

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.

• University of Florida Jacksonville Physicians Inc

  • Diagnostic Radiology Physician
  • Jacksonville, FL
  • NPI 1326208695
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians Inc

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1265693279
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville, FL
  • NPI 1104085752
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD

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

• Shands Jacksonville Medical Center Inc

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1144962408

  Hospital

  Care Compare affiliation
• Shands Jacksonville Medical Center Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1821186313
  Care Compare affiliation

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1770169476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-6340",
            "fax_number": "904-244-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME162748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Chen Peters, DPT
• Robert James Peters, DMD
• Anne M Petersen, PA
• Audrey Petersen, CCC-SLP
• Beyonce Petersen
• John M Petersen, D.O
• Peterson Assisted Living Facility
• Cheyenne W Peterson-Gurak, COTA
• Shilonda Peterson-Jackson
• Anna Peterson

• Emergency Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.