Active NPI
Courtney Pemberton, APRN
- Acute Care Nurse Practitioner
- Beavercreek, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- APRN.CNP.0038556
- Practice address
- 3535 Pentagon Blvd
Beavercreek, OH 45431-1705 - Phone
- (937) 702-4024
- Fax
- (937) 702-4035
- NPI assigned
- Nov 9, 2020
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 0038556 | OH | |
| Nurse Practitioner | 363L00000X | 0038556 | OH | |
| Acute Care Nurse Practitioner | 363LA2100X | APRN.CNP.0038556 | OH | Primary |
| Nurse Practitioner | 363L00000X | 3015281 | KY |
Addresses
Primary practice location
3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 757-2927
Other practice location 1
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 757-2927
Other practice location 2
3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 558-5281
Other practice location 3
405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 223-6837
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000
Hospital & facility affiliations
- University of Cincinnati Medical Center, LLC
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0038556 | OH | MD | Critical Care Medicine Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Cincinnati Physicians Company, LLC | Nurse Practitioner | Current | Accepting new patients |
| Summit Medical Group, Inc. | Current | Accepting new patients | |
| Kettering Independent Medical Group Inc | Current | Accepting new patients | |
| Summit Medical Group, Inc | Nurse Practitioner | Current | Accepting new patients |
Locations
1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353
1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000
3535 Pentagon Blvd
Ste 320
Beavercreek, OH 45431
Phone (937) 490-2270
3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281
2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523
405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200
4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910
1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306
7700 University Dr
West Chester, OH 45069
Phone (513) 298-3000
Interoperability endpoints
- cpemberton342276@direct-prd.stelizabeth.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Cincinnati, OH
- NPI 1801840434
Nurse Practitioner
-
- Orthopaedic Surgery Physician
- Miamisburg, OH
- NPI 1629387865
-
- Foot & Ankle Surgery Podiatrist
- Crestview Hills, KY
- NPI 1043188378
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cincinnati, OH
- NPI 1033154026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759276800000",
"number": "1932701604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 635283",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452635283",
"telephone_number": "859-757-2927",
"fax_number": "859-341-0203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 PENTAGON BLVD",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454311705",
"telephone_number": "937-702-4024",
"fax_number": "937-702-4035"
}
],
"practiceLocations": [
{
"address_1": "1 Medical Village Dr",
"address_purpose": "LOCATION",
"city": "Edgewood",
"state": "KY",
"postal_code": "410173403",
"country_code": "US",
"telephone_number": "859-757-2927",
"fax_number": "859-341-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3188 Bellevue Ave",
"address_purpose": "LOCATION",
"city": "Cincinnati",
"state": "OH",
"postal_code": "452192369",
"country_code": "US",
"telephone_number": "513-558-5281",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "405 W Grand Ave",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454057538",
"country_code": "US",
"telephone_number": "937-223-6837",
"fax_number": "937-223-3024",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEMBERTON",
"first_name": "COURTNEY",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-09",
"last_updated": "2025-10-01",
"certification_date": "2025-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LC0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Critical Care Medicine",
"state": "OH",
"license": "0038556",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "0038556",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "OH",
"license": "APRN.CNP.0038556",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3015281",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beavercreek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.