Individual provider Active NPI

Cortney Petty, WHNP-BC

  • Women's Health Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1184264400
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
1-148576 Issued in AL
Practice address
495 Taylor Rd
Montgomery, AL 36117-3513
Phone
(334) 747-8443
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LW0102X 1-148576 AL Primary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 1-148576 AL

Addresses

Primary practice location

495 Taylor Rd
Montgomery, AL 36117-3513

Mailing address

467 Sellars Rd
Montgomery, AL 36116-7502
Phone (334) 201-4463

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1-148576ALMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1184264400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 SELLARS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361167502",
            "telephone_number": "334-201-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173513",
            "telephone_number": "334-747-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "CORTNEY",
        "credential": "WHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AL",
            "license": "1-148576",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-148576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.