Courtney E Houde, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00295700 Issued in NJ

Practice address

103 Old Marlton Pike
Medford, NJ 08055

Phone

(609) 714-0202

NPI assigned

Oct 18, 2012

Sex

Female

Sole proprietor

No

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 NJ

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Dermatology LLCGroup PAC ID 5395703573, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Clark Dermatology LLC

  • Dermatology Physician
  • Clark, NJ
  • NPI 1851562425
  Medicare reassignment Care Compare group
• Clark Dermatology, LLC

  • Dermatology Physician
  • Staten Island, NY
  • NPI 1417316274
  NPD (past)

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992058689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 OLD MARLTON PIKE",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "08055",
            "telephone_number": "609-714-0202",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 OLD MARLTON PIKE",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "08055",
            "telephone_number": "609-714-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUDE",
        "first_name": "COURTNEY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055917",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00295700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James J Holton, MD
• Holy Home Health Care LLC
• Deborah Anne Hoover, D.M.D.
• Kenneth Scott Hoover, D.M.D.
• Dwight Henry Horch, LMFT
• Alison Hoyt, PSY.D.
• Deborah Hritz, LPC
• Danielle Hutchinson, MSW, LCSW
• Carl Franklin Hyder, MD
• Margaret Hyland

• Physician Assistant in Medford, NJ
• Providers in Medford, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
• 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.

Verify at the official NPI Registry.