COURTNEY MICHELLE ANDERSON (AGACNP-BC) – Gerontology Nurse Practitioner, NPI 1306621388

COURTNEY MICHELLE ANDERSON (AGACNP-BC) is a healthcare provider. based in Gray, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials AGACNP-BC. They hold a License No. RN250932 (GA). The NPI Number for COURTNEY MICHELLE ANDERSON (AGACNP-BC) is 1306621388

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
COURTNEY MICHELLE ANDERSON (AGACNP-BC)
NPI
1306621388
Phone
(478) 621-2100
Address
1005 BOULDER DR
Enumeration Date
29 August 2023
Last Update Date
14 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4786212100
Graduation Year
2023 (3 years ago)
PAC ID
5193189777
Group Practice PAC ID
0648421065
Professional Enrollment ID
I20230914003758
Address ID
GA310326141GR1005XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:2State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for COURTNEY MICHELLE ANDERSON (AGACNP-BC)

  • 1005 BOULDER DR

    GRAY, GA 310326141

    Phone: (478) 621-2100

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2023-11-14 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-09-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230914003758INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31032)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648421065View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA

Reviews

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Frequently asked questions

What federal number belongs to COURTNEY MICHELLE ANDERSON (AGACNP-BC)?
The federal identifier for COURTNEY MICHELLE ANDERSON (AGACNP-BC) is NPI 1306621388.
Is COURTNEY MICHELLE ANDERSON (AGACNP-BC) currently active in the NPI registry?
CMS-published data lists COURTNEY MICHELLE ANDERSON (AGACNP-BC) as an active registrant.
Can you summarize COURTNEY MICHELLE ANDERSON (AGACNP-BC)'s specialty in plain language?
Clinically, the directory lists COURTNEY MICHELLE ANDERSON (AGACNP-BC) with Gerontology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for COURTNEY MICHELLE ANDERSON (AGACNP-BC)?
We surface Gray, Georgia for COURTNEY MICHELLE ANDERSON (AGACNP-BC) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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