Courtney Nicole Jersey, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

4390 Issued in OK

Practice address

2301 W I 35 Frontage Rd
Edmond, OK 73013-8515

Phone

(405) 757-3365

Fax

(405) 757-3499

NPI assigned

Nov 2, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment
• Ou Health Partners, Inc

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1528642642
  Medicare reassignment
• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment
• Ou Health Partners, Inc

  • Prosthetic/Orthotic Supplier
  • Oklahoma City, OK
  • NPI 1447834460
  NPD
• Texas Children'S Hospital

  • Children's Hospital
  • Austin, TX
  • NPI 1194507947
  NPD (past)

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1952878472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 W I 35 FRONTAGE RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138515",
            "telephone_number": "405-757-3365",
            "fax_number": "405-757-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W I 35 FRONTAGE RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138515",
            "telephone_number": "405-757-3365",
            "fax_number": "405-757-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERSEY",
        "first_name": "COURTNEY",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA12364",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "4390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John William Jennings, MBA, OTR/L
• Serena Jensen, BA, LMSW, MWS U/S
• Jeremy Cole MD PLLC
• Jeremy Edwards DDS PLLC
• Cameron Andrew Jernigan
• Jessica Garba
• Jessica L. Plumley, PH.D. PLLC
• Jessica Yocum, MD, PLLC
• Shelby Jester, PA-C
• Alexis Jhanda

• Medical Physician Assistant in Edmond, OK
• Providers in Edmond, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.