NPIMap

Individual provider Active NPI

Eileen Shannon Courtleigh, P.A.

  • Physician Assistant
  • Sanford, NC
National Provider Identifier
1811044209
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11470 Issued in NC
Practice address
724 S Horner Blvd
Sanford, NC 27330-4822
Phone
(919) 776-6767
Fax
(919) 776-6773
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA002587L PA
Physician Assistant 363A00000X 0010-11470 NC Primary

Addresses

Primary practice location

724 S Horner Blvd
Sanford, NC 27330-4822

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Other practice location 1

417 Baltimore Pike
Springfield, PA 19064
Phone (484) 470-2600

Other names 1

  • Eileen Shannon Hubbard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041111000331 PA Practitioner - Physician Assistant 4183683972 Reassigns benefits to 1 organization
I20220201000593 NC Practitioner - Physician Assistant 4183683972 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians
Stedman-Wade Health Services, Inc.Group PAC ID 0042205189, 17 clinicians

Practice addresses (Care Compare)

17 Livermore Dr
Pembroke, NC 28372-7282
Phone (910) 522-7220

2313 Murchison Rd
Fayetteville, NC 28301-3517
Phone 91048366947057

24420 Marlboro St
Wagram, NC 28396-9600
Phone (910) 369-3136

410 -D S Jones St
Pembroke, NC 28372-7261
Phone (910) 504-8540

7118 Main St
Wade, NC 28395-9749
Phone 91048366947057

Hospital & facility affiliations

  • Scotland Memorial Hospital Hospital, Laurinburg, NC, CCN 340008
  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA002587LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan, Inc. CurrentSince Nov 2, 2015 Accepting new patients
FHPG, LLC CurrentSince Dec 27, 2021 Accepting new patients
Stedman-Wade Health Services, Inc. CurrentSince Apr 30, 2024 Accepting new patients
FHPG, LLC CurrentSince Dec 27, 2021 Accepting new patients
Einstein Practice Plan Inc CurrentSince Nov 2, 2015 Accepting new patients
Stedman-Wade Health Services, Inc. Past Accepting new patients
Dennis James Bonner, M.D., LTD PastSince Mar 13, 1998 Accepting new patients

Locations

2313 Murchison Rd
Fayetteville, NC 28301
Phone (910) 483-6694

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

5401 Old York Rd
#B
Philadelphia, PA 19141
Phone (215) 324-3399

Interoperability endpoints

  • Direct secure messaging: eileen.courtleigh.1@7912.direct.athenahealth.com

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1811044209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 S HORNER BLVD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304822",
            "telephone_number": "919-776-6767",
            "fax_number": "919-776-6773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 Baltimore Pike",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "PA",
            "postal_code": "19064",
            "country_code": "US",
            "telephone_number": "484-470-2600",
            "fax_number": "484-470-2601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COURTLEIGH",
        "first_name": "EILEEN",
        "middle_name": "SHANNON",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002587L",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EILEEN",
            "last_name": "HUBBARD",
            "middle_name": "SHANNON",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.