COURTNEY WATERS
NPI 1639571961
Physician Assistant in Jacksonville, FL

Q: What is Courtney Waters's NPI number?

The NPI number for Courtney Waters is 1639571961. It was assigned to this individual provider in the NPPES registry on September 18, 2014.

Q: What is Courtney Waters's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Courtney Waters was last updated on May 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 18, 2014PECOS Enrolled

11513 N MAIN ST, JACKSONVILLE, FL 32218(904) 751-6200 Get Directions Write a Review

NPPES record last updated: May 10, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 10, 2021, Apr 8, 2020 (2 updates tracked since 2020).

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About Courtney Waters NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COURTNEY WATERS (NPI 1639571961) is an individual physician assistant in Jacksonville, Florida, licensed in Florida (PA9108237) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1639571961

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameCOURTNEY WATERS

Location Address11513 N MAIN STJacksonville, FL 32218-4002

Mailing Address2675 Winkler Ave Fl 2Fort Myers, FL 33901-9342 · (877) 856-3774

Phone(904) 751-6200

Sole ProprietorNo

Enumeration DateSeptember 18, 2014

Last NPPES UpdateMay 10, 20212 updates tracked since enumeration

NPPES CertifiedApril 28, 2021

✔ NPI 1639571961 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in FL · PA9108237✔ Licensed in FL · PAT9108237

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

11513 N MAIN ST, Jacksonville, FL 32218

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Secondary Practice Location 1

Location 111513 N Main StJacksonville, FL 32218-4002 · Phone (904) 751-6200 · Fax (904) 751-1600

Other Identifiers 1

OtherKO410FL · Medicare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Courtney Waters is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32218 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier15 claims15 services$195.08 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIFFANY B JONES

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