NPIMap

Individual provider Active NPI

Courtney Ann Gearhart, PA-C

  • Physician Assistant
  • Brownstown TWP, MI
National Provider Identifier
1982911871
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005870 Issued in MI
Practice address
23050 West Rd
Ste 120
Brownstown TWP, MI 48183-1472
Phone
(734) 671-1510
NPI assigned
Sep 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601005870 MI Primary

Addresses

Primary practice location

23050 West Rd
Ste 120
Brownstown TWP, MI 48183-1472

Mailing address

1640 Fort Street
Suite D Attn Denise
Trenton, MI 48183
Phone (734) 391-3057

Other identifiers 2

IdentifierTypeStateIssuer
0H28864OtherMIBLUE CROSS
1710315932OtherMIGROUP NPI HENRY FORD WYANDOTTE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110218001018 MI Practitioner - Physician Assistant 7113108416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Wyandotte Hospital 194 clinicians

Practice addresses (Care Compare)

2070 Biddle Ave
Suite 2
Wyandotte, MI 48192-4080
Phone (734) 284-7482

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6000

Hospital & facility affiliations

  • Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146
  • Corewell Health Trenton Hospital Hospital, Trenton, MI, CCN 230176
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Aug 1, 2016 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Aug 24, 2014 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Aug 24, 2014 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Aug 1, 2016 Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients
Henry Ford Wyandotte Hospital Physician Assistant Past Accepting new patients

Locations

23050 West Rd
Ste 120
Brownstown Twp, MI 48183
Phone (734) 671-1510

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1640 Fort St
Ste D
Trenton, MI 48183
Phone (734) 391-3057

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

Interoperability endpoints

  • Direct secure messaging: cgearhart57522@direct.hfhs.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

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": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1982911871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 FORT STREET",
            "address_2": "SUITE D ATTN DENISE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "48183",
            "telephone_number": "734-391-3057",
            "fax_number": "734-391-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23050 WEST RD",
            "address_2": "STE 120",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831472",
            "telephone_number": "734-671-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEARHART",
        "first_name": "COURTNEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0H28864",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI HENRY FORD WYANDOTTE",
            "identifier": "1710315932",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownstown TWP, MI

Sources for this page

Verify at the official NPI Registry.