Individual provider Active NPI

Courtney M Wilmot, NURSE PRACTITIONER

  • Women's Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1093338873
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
95014203 Issued in CA
Practice address
400 W 30TH St
Los Angeles, CA 90007-3320
Phone
(213) 284-3200
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 95014203 CA Primary

Addresses

Primary practice location

400 W 30TH St
Los Angeles, CA 90007-3320

Mailing address

1022 Tropic LN
Santa Ana, CA 92705-2951

Other practice location 1

1125 10th St
Sacramento, CA 95814-3503
Phone (916) 444-7966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95014203CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Greater New York Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: courtney.wilmotnp.p1@direct.plannedparenthoodla.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1093338873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 TROPIC LN",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927052951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 30TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073320",
            "telephone_number": "213-284-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 10th St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958143503",
            "country_code": "US",
            "telephone_number": "916-444-7966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILMOT",
        "first_name": "COURTNEY",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95014203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.