Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Courtney Rae Criswell, PA-C

Individual provider Physician Assistant · NPI 1629535307

Courtney Rae Criswell, PA-C is a Physician Assistant in Jacksonville, Florida. Qualified in 2018, 8 years ago. Practices with Jacksonville Spine Center PA, a 38-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida and Georgia.

Years since qualifying
8
Licensed in
FL, GA
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5191 First Coast Tech Pkwy Fl 3
Jacksonville, FL 32224-0609
Phone: (904) 223-3321
Fax: (904) 223-2169
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3408 Trout St, Brunswick, GA 31520-3622 — (912) 466-9111

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9111862 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 10406 (GA)

Record details

NPI number1629535307
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedFebruary 28, 2019
Last updated in NPPESSeptember 20, 2024
Certification dateSeptember 20, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Jacksonville Spine Center Pa — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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