Individual provider Active NPI

Courtney Lee Green, FNP-C

  • Family Nurse Practitioner
  • Demorest, GA
National Provider Identifier
1801454749
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN257515 Issued in GA
Practice address
541 441 Historic Hwy N
Demorest, GA 30535-4528
Phone
(770) 219-8720
NPI assigned
Jun 5, 2019
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN257515 GA Primary
Registered Nurse 163W00000X RN257515 GA

Addresses

Primary practice location

541 441 Historic Hwy N
Demorest, GA 30535-4528

Mailing address

PO Box 742616
Atlanta, GA 30374-2616

Other practice location 1

101 Adams Dr
Demorest, GA 30535-4565
Phone (706) 778-3912

Other identifiers 1

IdentifierTypeStateIssuer
003122026DMedicaidGA

Other names 1

  • Courtney Lee Voss Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20211111001979 GA Practitioner - Nurse Practitioner 7517356660 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 219-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN257515GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Myfamilydoc LLC CurrentSince Nov 9, 2021 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Apr 1, 2023 Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Jun 24, 2023 Accepting new patients

Locations

101 Adams Dr
Demorest, GA 30535
Phone (470) 238-8996

1070 441 Historic Hwy
Ste De
Demorest, GA 30535
Phone (706) 778-3259

541 441 Historic Hwy N
Demorest, GA 30535
Phone (706) 839-4000

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

Organizations & group practices 3

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1801454749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 441 HISTORIC HWY N",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "305354528",
            "telephone_number": "770-219-8720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Adams Dr",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "305354565",
            "country_code": "US",
            "telephone_number": "706-778-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "COURTNEY",
        "middle_name": "LEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN257515",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN257515",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003122026D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "VOSS",
            "middle_name": "LEE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Demorest, GA

Sources for this page

Verify at the official NPI Registry.