Courtney Koppenal Kovalick, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-01066 Issued in NC

Practice address

3840 Ed Dr
Suite 111
Raleigh, NC 27612-8005

Phone

(919) 571-3661

NPI assigned

Dec 26, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Carolina Endocrine, P.a.

  • Clinic/Center
  • Raleigh, NC
  • NPI 1093770240
  NPD (past)

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1831373984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 ED DR",
            "address_2": "SUITE 111",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128005",
            "telephone_number": "919-571-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 ED DR",
            "address_2": "SUITE 111",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128005",
            "telephone_number": "919-571-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALICK",
        "first_name": "COURTNEY",
        "middle_name": "KOPPENAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-01066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Kovach, OTD, OTR/L
• Michael D. Kovach, LMFT
• Katharine Denues Kovacs, PA
• Miranda A Kovacs
• Tricia Kovacs
• Tatiana Kovtoun, MD
• Jennie L Kowaleski, PA-C
• Dylan Joseph Kowalewski, PA
• Kaitlynn Donovan Kowalick, DPT
• Brooke Sandra Kowalski, MSW, LCSWA

• Medical Physician Assistant in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.