Individual provider Active NPI

Courtney Shea Werner, PNP

  • Pediatric Nurse Practitioner
  • Burleson, TX
National Provider Identifier
1235466624
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
675651 Issued in TX
Practice address
344 SW Wilshire Blvd Ste I
Burleson, TX 76028-5350
Phone
(817) 442-3040
NPI assigned
Nov 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 675651 TX Primary

Addresses

Primary practice location

344 SW Wilshire Blvd Ste I
Burleson, TX 76028-5350

Mailing address

5110 Landover Hills LN
Arlington, TX 76017-4920
Phone (817) 504-9807

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100629000178 TX Practitioner - Nurse Practitioner 7911038385 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baird Pediatrics PLLC CurrentSince Aug 28, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 6, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 6, 2018 Accepting new patients

Locations

344 SW Wilshire Blvd
Ste I
Burleson, TX 76028
Phone (318) 510-1720

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20383/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1235466624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 LANDOVER HILLS LN",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760174920",
            "telephone_number": "817-504-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 SW WILSHIRE BLVD STE I",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285350",
            "telephone_number": "817-442-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "COURTNEY",
        "middle_name": "SHEA",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "675651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.