Individual provider Active NPI

Courtney Anne Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1063799450
Registry record updated Apr 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
706304 Issued in TX
Practice address
2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817
Phone
(713) 620-4000
NPI assigned
Nov 14, 2011
Last updated
Apr 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 706304 TX Primary

Addresses

Primary practice location

2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817

Mailing address

2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817
Phone (713) 620-4000

Other identifiers 4

IdentifierTypeStateIssuer
291783301MedicaidTX
291783302MedicaidTX
8507UCOtherTXBLUE CROSS BLUE SHIELD
P01095328OtherTXRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130115000186 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103087580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians

Practice addresses (Care Compare)

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Mar 19, 2020 Accepting new patients

Locations

2020 E 28th St
Ste 100
Minneapolis, MN 55407
Phone (612) 455-0612

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

2945 Hazelwood St
Ste 300
Saint Paul, MN 55109
Phone (651) 471-9701

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

345 Sherman St
Ste 100
Saint Paul, MN 55102
Phone (651) 241-5525

345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

3580 Arcade St
Ste 20
Vadnais Heights, MN 55127

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

2080 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 642-9199

2080 Woodwinds Dr
Ste 200
Woodbury, MN 55125
Phone (651) 642-1106

7115 Tamarack Rd
Ste 200
Woodbury, MN 55125
Phone (651) 968-5468

Organizations & group practices 1

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397260800000",
    "number": "1063799450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "address_2": "STE. 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574817",
            "telephone_number": "713-620-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "address_2": "STE. 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574817",
            "telephone_number": "713-620-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "COURTNEY",
        "middle_name": "ANNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2014-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "706304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291783301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291783302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8507UC",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01095328",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2014; 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.