Individual provider Active NPI

Courtney Byrum, MS, RD, LD

  • Registered Dietitian
  • Little Rock, AR
National Provider Identifier
1023426327
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1510 Issued in AR
Practice address
4 Shackleford PLZ Ste 209
Little Rock, AR 72211-1844
Phone
(501) 779-8327
Fax
(501) 500-5750
NPI assigned
Jul 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1510 AR Primary

Addresses

Primary practice location

4 Shackleford PLZ Ste 209
Little Rock, AR 72211-1844

Mailing address

4 Shackleford PLZ Ste 209
Little Rock, AR 72211-1844
Phone (501) 779-8327

Other names 1

  • Courtney Condren Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211220002363 AR Practitioner - Registered Dietitian Or Nutrition Professional 2769873124 Practice locations: Little Rock, AR

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Shackleford PLZ
Suite 209
Little Rock, AR 72211-1844
Phone (501) 779-8327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Condren Family Nutrition Dietitian, Registered CurrentSince Sep 1, 2021 Accepting new patients
Courtney Byrum Rd LLC Dietitian, Registered CurrentSince Nov 1, 2021 Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients

Locations

10020 N Rodney Parham Rd
Ste F
Little Rock, AR 72227
Phone (501) 779-8327

4 Shackleford Plz
Ste 209
Little Rock, AR 72211
Phone (501) 779-8327

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1023426327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SHACKLEFORD PLZ STE 209",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111844",
            "telephone_number": "501-779-8327",
            "fax_number": "501-500-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHACKLEFORD PLZ STE 209",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111844",
            "telephone_number": "501-779-8327",
            "fax_number": "501-500-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRUM",
        "first_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-30",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AR",
            "license": "1510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "CONDREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.