Courtney Lee Littere, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-11415 Issued in NC

Practice address

1806 Glendale Dr SW
Wilson, NC 27893-4402

Phone

(252) 243-0566

NPI assigned

Jul 22, 2021

Last updated

Mar 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Polley Clinic of Dermatology and Dermatologic SurgeryGroup PAC ID 9638134364, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Polley Clinic of Dermatology & Dermatologic Surgery

  • Dermatopathology Physician
  • Wilson, NC
  • NPI 1104847714
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1992378251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 PARK AVE",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458979",
            "telephone_number": "716-998-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 GLENDALE DR SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934402",
            "telephone_number": "252-243-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTERE",
        "first_name": "COURTNEY",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liles Family Chiropractic PLLC
• Beth A Liles, DC
• Matthew T Liles, DC
• Brooke Renee Lindsay, PA-C
• Lisal B. Isaacs, DMD, P.a.
• Beverly Lucille Little, LPCA
• Monte Frank Little, LPT
• Tonya Dee Smith Little, M.D.
• Livedo USA Inc (TYE Medical)
• Lois' House

• Physician Assistant in Wilson, NC
• Providers in Wilson, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.