Individual provider Active NPI

Courtney Octave Howell, PNP

  • Pediatric Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1225161763
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP2628 Issued in AZ
Practice address
1432 S Dobson Rd
Suite 301
Mesa, AZ 85202-4768
Phone
(480) 412-7120
Fax
(480) 412-5611
NPI assigned
Mar 13, 2007
Last updated
Aug 2, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP2628 AZ Primary
Registered Nurse 163W00000X RN119828 AZ

Addresses

Primary practice location

1432 S Dobson Rd
Suite 301
Mesa, AZ 85202-4768

Mailing address

1432 S Dobson Rd
Suite 301
Mesa, AZ 85202-4768
Phone (480) 412-7120

Other identifiers 1

IdentifierTypeStateIssuer
198698MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070503000088 AZ Practitioner - Nurse Practitioner 9133225436 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN119828AZMDRegistered Nurse
AP2628AZMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children's Medical Group CurrentSince Jul 3, 2011 Accepting new patients
Phoenix Children's Medical Group CurrentSince Jul 3, 2011 Accepting new patients
Phoenix Children's Hospital Current Accepting new patients

Locations

5757 W Thunderbird Rd
Ste E353
Glendale, AZ 85306
Phone (480) 315-8412

1551 E Tangerine Rd
Ste 141
Oro Valley, AZ 85755
Phone (520) 320-7999

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

726 Gail Gardner Way
Ste A
Prescott, AZ 86305
Phone (928) 442-8660

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1225161763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD",
            "address_2": "SUITE 301",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024768",
            "telephone_number": "480-412-7120",
            "fax_number": "480-412-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD",
            "address_2": "SUITE 301",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024768",
            "telephone_number": "480-412-7120",
            "fax_number": "480-412-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWELL",
        "first_name": "COURTNEY",
        "middle_name": "OCTAVE",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP2628",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN119828",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198698",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.