Individual provider Active NPI

Courtney McClurkin, DPM

  • Podiatrist
  • Dallas, TX
National Provider Identifier
1053838177
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
3023 Issued in TX
Practice address
1130 Beachview St Ste 200
Dallas, TX 75218-3705
Phone
(214) 321-9410
NPI assigned
Aug 29, 2017
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 3023 TX Primary

Addresses

Primary practice location

1130 Beachview St Ste 200
Dallas, TX 75218-3705

Mailing address

PO Box 180221
Dallas, TX 75218-0221
Phone (214) 321-9410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200819002978 TX Practitioner - Podiatry 9830515998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bravura Foot and Ankle Specialists, PLLCGroup PAC ID 9133547516, 2 clinicians

Practice addresses (Care Compare)

Dallas, TX 75227
Phone (713) 252-5793

1130 Beachview St
Suite 200
Dallas, TX 75218-3705
Phone (214) 321-9410

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue19
Removal of nail tissue109
Removal or shaving of skin growth64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3023TXMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bravura Foot and Ankle Specialists, PLLC Podiatrist CurrentSince Oct 1, 2023 Accepting new patients
Brett Allan Gabriel Podiatrist PastSince Oct 1, 2023 Accepting new patients
Texas Group PLLC Past Accepting new patients

Locations

1130 Beachview St
Ste 200
Dallas, TX 75218
Phone (214) 321-9410

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1053838177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180221",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752180221",
            "telephone_number": "214-321-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 BEACHVIEW ST STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183705",
            "telephone_number": "214-321-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURKIN",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "3023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.