Individual provider Active NPI

Courtney B Hixson, PA-C

  • Physician Assistant
  • Prestonsburg, KY
National Provider Identifier
1780170050
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC719 Issued in KY
Practice address
104 S Front Ave
Prestonsburg, KY 41653-1614
Phone
(606) 886-8572
Fax
(606) 886-4433
NPI assigned
Jul 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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 TC719 KY Primary

Addresses

Primary practice location

104 S Front Ave
Prestonsburg, KY 41653-1614

Mailing address

104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210510002763 KY Practitioner - Physician Assistant 1153730858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TC719KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Comprehensive Care Center, Inc. CurrentSince Apr 12, 2021 Accepting new patients
Mountain Comprehensive Care Center, Inc. CurrentSince Apr 12, 2021 Accepting new patients
Mountain Comprehensive Care Center, Inc. Past Accepting new patients

Locations

26229 US Highway 119 N
Ste A
Belfry, KY 41514
Phone (606) 353-9226

263 Ky Route 122
Martin, KY 41649
Phone (606) 949-1555

1110 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345

838 S Mayo Trl
Paintsville, KY 41240
Phone (606) 788-1345

1330 S Mayo Trl
Ste 201
Pikeville, KY 41501
Phone (606) 432-0123

118 River Dr
Pikeville, KY 41501
Phone (606) 432-3143

104 S Front Ave
Prestonsburg, KY 41653
Phone (606) 688-6857

540 Parkway Dr
Salyersville, KY 41465

Interoperability endpoints

  • Direct secure messaging: courtney.hixson.p1@direct.mtcomp.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1780170050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIXSON",
        "first_name": "COURTNEY",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prestonsburg, KY

Sources for this page

Verify at the official NPI Registry.