COURTNEY MARIE WEDGEWORTH (NPI# 1073041158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073041158 |
| Entity Type | Individual |
| Full Name | COURTNEY MARIE WEDGEWORTH |
| Credential | PA-C |
| Practice Address |
537 Union Ave Grants Pass OR 97527-5543 |
| Practice Telephone | 5414767775 |
| Mailing Telephone | 5415072150 |
| Mailing Fax Number | 5415072151 |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2017-11-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
PA184237 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
537 UNION AVE |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97527-5543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902832652 | Samuel D. Mcreynolds | Physician Assistant | 537 Union Ave, Grants Pass, OR 97527-5543 | 2006-06-24 |
| 1255976197 | Alisha Naomi Zauher | Nurse Practitioner | 537 Union Ave, Grants Pass, OR 97527 | 2019-11-14 |
| 1023575891 | Kristen Clark | Specialist/Technologist | 537 Union Ave, Grants Pass, OR 97527-5543 | 2019-02-27 |
| 1225516537 | Jessie Kristen Hermant | Nurse Practitioner | 537 Union Ave, Grants Pass, OR 97527-5543 | 2018-07-30 |
| 1760973739 | Taira Coryn Butler | Registered Nurse | 537 Union Ave, Grants Pass, OR 97527 | 2018-05-24 |
| 1073063772 | Beau J Shelton | Physician Assistant | 537 Union Ave, Grants Pass, OR 97527-5543 | 2016-10-06 |
| 1578918546 | Gabrielle Marie Fey | Registered Nurse | 537 Union Ave, Grants Pass, OR 97527-5543 | 2016-04-27 |
| 1093169104 | App Ent | Otolaryngology | 537 Union Ave, Second Floor -2c, Grants Pass, OR 97527-5543 | 2016-04-15 |
| 1811341928 | App Orthopedic Clinic | Orthopaedic Surgery | 537 Union Ave, Second Floor 2a, Grants Pass, OR 97527-5543 | 2016-04-15 |
| 1124472246 | App Urology Clinic | Urology | 537 Union Ave, Second Floor 2b, Grants Pass, OR 97527-5543 | 2016-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528618600 | Sandra J Campos | Technician | 365 Sleepy Hollow Loop, Grants Pass, OR 97527 | 2019-09-19 |
| 1720501026 | Kelly Bates | Massage Therapist | 501 Cheney Creek Rd, Grants Pass, OR 97527 | 2017-07-19 |
| 1740650134 | Sara Brelsford | Nurse Practitioner | 1075 Sw Grandview Avenue, Suite 200, Grants Pass, OR 97527 | 2015-09-29 |
| 1962816348 | Kimberly Hathaway | Counselor | 320 Ramsey Place, Grants Pass, OR 97527 | 2014-06-13 |
| 1801216999 | Christina Ann Marie Schultz | Massage Therapist | 242 Curtis Drive, Grants Pass, OR 97527 | 2014-04-16 |
| 1013343359 | Shaunte Angelique Duron | Counselor | 711 Sw Ramsey Avenue, Grants Pass, OR 97527 | 2013-09-18 |
| 1063848547 | Megan Faye Armstrong | Behavioral Analyst | 715 Ramsey Aveenue, Grants Pass, OR 97527 | 2013-09-17 |
| 1124454608 | Mark Albert Cook | Behavioral Analyst | 1153 Sw Cal Allen Lane, Grants Pass, OR 97527 | 2013-09-17 |
| 1952741969 | Mitchell K Sheeler | Denturist | 1850 Williams Hwy, Grants Pass, OR 97527 | 2013-07-05 |
| 1790038339 | White City Vamc | Clinic/Center | 1877 Williams Highway, Grants Pass, OR 97527 | 2012-10-19 |
| Find all providers in zip 97527 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851514343 | Michelle Bleynat Vessely | Otolaryngology | 6485 Sw Borland Rd Ste B, Tualatin, OR 97062-9762 | 2007-04-11 |
| 1447632328 | Ear, Nose and Throat Associates, LLC. | Otolaryngology | 900 Se Oak St Ste 201, Hillsboro, OR 97123-4287 | 2015-06-26 |
| 1952672289 | David Sining Chen | Otolaryngology | 3303 Sw Bond Ave Ste 5, Portland, OR 97239-4501 | 2012-01-18 |
| 1619028693 | Steven P Gabel, Md, PC | Otolaryngology | 12115 Sw 70th Ave Ste 200, Tigard, OR 97223 | 2007-01-16 |
| 1952476350 | Daniel Mac Dowell Wayman | Otolaryngology | 555 Black Oak Dr, Suite 210, Medford, OR 97504-8447 | 2006-11-21 |
| City | GRANTS PASS |
| Zip Code | 97527 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.