Organization Active NPI

Courtney E Sinclair MD PC

  • Gynecology Physician
  • Canton, GA
National Provider Identifier
1902085939
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
COURTNEY E SINCLAIR MD PC
Practice address
310 Paper Trail Way
Suite 109
Canton, GA 30115-5203
Phone
(770) 720-4100
Fax
(770) 720-4141
NPI assigned
Oct 26, 2007
Last updated
Oct 26, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Authorized official

Name
Courtney E Sinclair, M.D.NPI 1184717035
Title
President
Phone
(770) 720-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X NU Primary

Addresses

Primary practice location

310 Paper Trail Way
Suite 109
Canton, GA 30115-5203

Mailing address

310 Paper Trail Way
Suite 109
Canton, GA 30115-5203
Phone (770) 720-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080506000025 GA Part B Supplier - Clinic/Group Practice 4981783784 Practice locations: Canton, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1077119Courtney E Sinclair MD310 Paper Trail Way Suite 109, Canton, GA 30115Provider-performed microscopyDec 2, 2027

National Provider Directory

National Provider Directory

Locations

310 Paper Trail Way
Ste 109
Canton, GA 30115
Phone (770) 720-4100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1902085939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 PAPER TRAIL WAY",
            "address_2": "SUITE 109",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155203",
            "telephone_number": "770-720-4100",
            "fax_number": "770-720-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 PAPER TRAIL WAY",
            "address_2": "SUITE 109",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155203",
            "telephone_number": "770-720-4100",
            "fax_number": "770-720-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURTNEY E SINCLAIR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "SINCLAIR",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-720-4100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.