Courtney Rae Gordon, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

903982 Issued in MS

Practice address

410 Orchard Park
Ridgeland, MS 39157-5135

Phone

(601) 957-0727

NPI assigned

Jul 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Rae Houston Former name

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Medical Consultants LLCGroup PAC ID 9830496314, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
• Centerwell Home Health Home health agency, Flowood, MS, CCN 257126

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8276/brand/1/csg/1/fhir/r4

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.

• Southern Medical Consultants LLC

  • Primary Care Nurse Practitioner
  • Ridgeland, MS
  • NPI 1215396577
  Medicare reassignment Care Compare group NPD
• Pioneer Health Care , LLC

  • General Practice Physician
  • Bassfield, MS
  • NPI 1336384742
  Medicare reassignment NPD
• Prime Care Clinic of Clinton, LLC

  • Adult Health Nurse Practitioner
  • Clinton, MS
  • NPI 1790444263
  Medicare reassignment NPD
• Conx Care Corporation

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1548183510
  NPD (past)
• Trustcare Clinics, LLC

  • General Practice Physician
  • Ridgeland, MS
  • NPI 1821589318
  NPD (past)
• Trustcare Primary Care, LLC

  • Family Medicine Physician
  • Madison, MS
  • NPI 1174078554
  NPD (past)

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

• Home Health Care Affiliates of Central Mississippi, LLC

  • Home Health Agency
  • Flowood, MS
  • NPI 1417935578
  Care Compare affiliation
• Sta-Home Health Agency of Jackson, Inc.

  • Home Health Agency
  • Clinton, MS
  • NPI 1356482749
  Care Compare affiliation

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

{
    "created_epoch": "1593907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1891312948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7048 OLD CANTON RD STE 2E",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571021",
            "telephone_number": "601-992-9790",
            "fax_number": "601-992-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 ORCHARD PARK",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575135",
            "telephone_number": "601-957-0727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Dyess Rd",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391574410",
            "country_code": "US",
            "telephone_number": "601-767-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "COURTNEY",
        "middle_name": "RAE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-05",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "903982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "HOUSTON",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily McDill Gonseth
• Jordyn Baleigh Gooch, OTR/L
• Monique Gooden, FNP-C
• Diane V. Goodloe, OT
• Brian Heath Gordon, PHD
• Phoebe Gordon, MT
• Bethany Harrelson Gough, MS CCC-SLP
• Gptrs II
• Gptrs II
• Gptrs II

• Nurse Practitioner in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.