Courtney Marie Brummel, MSN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Bolivar, MO
NPI 1164074175 · NPPES record last updated Jul 10, 2019
Key facts
- NPI
- 1164074175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2019025783 (MO)
- Practice address
- 1120 S Springfield Ave
Bolivar, MO 65613-2512 - Phone
- (417) 326-7814
- NPI assigned
- Jul 10, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200709002738 | MO | Practitioner - Nurse Practitioner | 7416370440 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Resource Group | Current |
Accepting new patients | |
| Citizens Memorial Healthcare | Current |
Accepting new patients | |
| Ozarks Resource Group | Current |
Accepting new patients | |
| Citizens Memorial Healthcare | Current |
Accepting new patients |
Locations
1120 S Springfield Ave
Bolivar, MO 65613
Phone (417) 326-4000
1300 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-7676
1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000
18614 Jackson St
Hermitage, MO 65668
Phone (417) 745-0103
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2019025783 | MO | Yes |
Addresses
Primary practice location
1120 S Springfield Ave
Bolivar, MO 65613-2512
Mailing address
1120 E Forest Ridge Dr
Bolivar, MO 65613-1075
Phone (417) 298-6847
Other providers in Bolivar, MO
- Rebecca L. Briggs
- Carmen Broadbent
- Jason Brooks
- Garry J Brown
- Ira Jason Brown
- Susan Kay Buchen
- Samuel Christian Buesking
- Mark J Bult
- Jennifer A Bushre
- Leah M Cagle
All providers in Bolivar, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.