Individual provider Active NPI

Cora Courage, PSYD

  • Clinical Psychologist
  • Jamestown, ND
National Provider Identifier
1215087200
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
592 Issued in ND
Practice address
715 10TH St SE
Jamestown, ND 58401-5728
Phone
(701) 952-9600
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 379 WY
Clinical Psychologist 103TC0700X 592 ND Primary

Addresses

Primary practice location

715 10TH St SE
Jamestown, ND 58401-5728

Mailing address

715 10TH St SE
Jamestown, ND 58401-5728
Phone (701) 952-9600

Other names 1

  • Waynette Box Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
379WYMDInternal Medicine Physician
592NDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Dakota State Hospital CurrentSince Jul 2, 2021 Accepting new patients

Locations

600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644

2605 Circle Dr
Jamestown, ND 58401
Phone (701) 253-3650

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1215087200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 10TH ST SE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584015728",
            "telephone_number": "701-952-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 10TH ST SE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584015728",
            "telephone_number": "701-952-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURAGE",
        "first_name": "CORA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WY",
            "license": "379",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WAYNETTE",
            "last_name": "BOX",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.