Active NPI
Courtney Kathleen Kozek, PA-C
- Physician Assistant
- Mentor, OH
National Provider Identifier
1821547274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.004792RX
- Practice address
- 9500 Mentor Ave
#100
Mentor, OH 44060-8713 - Phone
- (440) 352-4880
- NPI assigned
- Sep 27, 2016
- Last updated
- Feb 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.004792RX | OH | Primary |
Addresses
Primary practice location
9500 Mentor Ave
#100
Mentor, OH 44060-8713
Mailing address
9500 Mentor Ave
#100
Mentor, OH 44060-8713
Phone (440) 352-4880
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Courtney.riggans@lhpg.cernerdirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2023 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- courtney.riggans@lhpg.cernerdirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1821547274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 MENTOR AVE",
"address_2": "#100",
"city": "MENTOR",
"state": "OH",
"postal_code": "440608713",
"telephone_number": "440-352-4880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 MENTOR AVE",
"address_2": "#100",
"city": "MENTOR",
"state": "OH",
"postal_code": "440608713",
"telephone_number": "440-352-4880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZEK",
"first_name": "COURTNEY",
"middle_name": "KATHLEEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-27",
"last_updated": "2021-02-26",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.004792RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Courtney.riggans@lhpg.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "Baseline West Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "9500 Mentor Ave",
"address_2": "#100",
"city": "Mentor",
"state": "OH",
"country_code": "US",
"postal_code": "440608713",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.