Individual provider Active NPI

Courtney Leigh Skaradzinski, NP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1972217834
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5017460 Issued in NC
Practice address
1901 Randolph Rd
Charlotte, NC 28207-1101
Phone
(704) 384-5429
Fax
(704) 384-5424
NPI assigned
Jan 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08220444 NC
Nurse Practitioner 363L00000X 5017460 NC Primary

Addresses

Primary practice location

1901 Randolph Rd
Charlotte, NC 28207-1101

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

200 Hawthorne Ln
Charlotte, NC 28204-2515
Phone (704) 384-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 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

Enrollment IDStateProvider typePAC IDDetails
I20230313002177 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325412463 Reassigns benefits to 1 organization
I20250108000289 NC Practitioner - Nurse Practitioner 8325412463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

330 Billingsley Rd
Suite 202
Charlotte, NC 28211-5020
Phone (704) 316-2350

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F08220444NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Nov 16, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Nov 16, 2024 Accepting new patients
Providence Anesthesiology Associates, P.a. CurrentSince Feb 1, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

3735 Glenlake Dr
Ste 250
Charlotte, NC 28208
Phone (704) 749-5801

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: cskaradzinski1121911@direct.novanthealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1972217834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071101",
            "telephone_number": "704-384-5429",
            "fax_number": "704-384-5424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawthorne Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042515",
            "country_code": "US",
            "telephone_number": "704-384-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKARADZINSKI",
        "first_name": "COURTNEY",
        "middle_name": "LEIGH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F08220444",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5017460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.