Individual provider Active NPI

Courtney Brooke Matthews, CRNP

  • Family Nurse Practitioner
  • Meadville, PA
National Provider Identifier
1952153629
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP029558 Issued in PA
Practice address
16792 Conneaut Lake Rd
Meadville, PA 16335-3748
Phone
(814) 373-2335
Fax
(814) 373-2338
NPI assigned
Apr 4, 2024
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP029558 PA Primary

Addresses

Primary practice location

16792 Conneaut Lake Rd
Meadville, PA 16335-3748

Mailing address

1034 Grove St
Meadville, PA 16335-2945
Phone (814) 333-5000

Other practice location 1

406 W Oak St
Titusville, PA 16354-1404
Phone (814) 373-2335

Other names 1

  • Courtney King Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240430004524 PA Practitioner - Nurse Practitioner 5395185045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadville Medical CenterGroup PAC ID 4284535790, 139 clinicians

Practice addresses (Care Compare)

16792 Conneaut Lake Rd
Meadville, PA 16335-3748
Phone (814) 373-2335

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meadville Medical Center CurrentSince Apr 1, 2024 Accepting new patients
Meadville Medical Center CurrentSince Apr 1, 2024 Accepting new patients

Locations

1034 Grove St
Meadville, PA 16335
Phone (814) 333-5728

16792 Conneaut Lake Rd
Meadville, PA 16335
Phone (814) 373-2335

16792 Conneaut Lake Rd
#G
Meadville, PA 16335
Phone (814) 373-2335

751 Liberty St
Meadville, PA 16335
Phone (814) 333-5081

406 W Oak St
Titusville, PA 16354
Phone (814) 827-1851

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1952153629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-333-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16792 CONNEAUT LAKE RD",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353748",
            "telephone_number": "814-373-2335",
            "fax_number": "814-373-2338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "PA",
            "postal_code": "163541404",
            "country_code": "US",
            "telephone_number": "814-373-2335",
            "fax_number": "814-373-2338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "COURTNEY",
        "middle_name": "BROOKE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP029558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "KING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.