Individual provider Active NPI

Courtney Dannielle Murtagh, WHNP

  • Nurse Practitioner
  • Flowood, MS
National Provider Identifier
1053095885
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
905930 Issued in MS
Practice address
2925 Layfair Dr
Flowood, MS 39232-9507
Phone
(601) 984-6740
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 905930 MS Primary

Addresses

Primary practice location

2925 Layfair Dr
Flowood, MS 39232-9507

Mailing address

120 Lakeview Rd
Brandon, MS 39047-9222
Phone (601) 842-8177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213000092 MS Practitioner - Nurse Practitioner 1254783350 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

505 Airport Rd
Suite D
Forest, MS 39074-4033
Phone (601) 333-0947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Nov 28, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Nov 28, 2023 Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

2925 Layfair Dr
Flowood, MS 39232
Phone (601) 984-5314

1010 Lakeland Pl
Flowood, MS 39232
Phone (601) 815-0600

505 Airport Rd
Ste D
Forest, MS 39074
Phone (601) 333-0947

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHAJCA/Endpoint/GHAJCA

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1053095885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LAKEVIEW RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390479222",
            "telephone_number": "601-842-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 LAYFAIR DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329507",
            "telephone_number": "601-984-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURTAGH",
        "first_name": "COURTNEY",
        "middle_name": "DANNIELLE",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "905930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.