Individual provider Active NPI

Courtney Nevins

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1235801630
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1056063 Issued in TX
Practice address
17290 Preston Rd Ste 206
Dallas, TX 75252-4028
Phone
(972) 846-0448
NPI assigned
Oct 4, 2021
Sex
Female
Sole proprietor
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1056063 TX Primary

Addresses

Primary practice location

17290 Preston Rd Ste 206
Dallas, TX 75252-4028

Mailing address

17290 Preston Rd Ste 206
Dallas, TX 75252-4028
Phone (972) 846-0448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220222000364 TX Practitioner - Nurse Practitioner 1951795780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comfort Visiting Physician LLCGroup PAC ID 2668994641, 3 clinicians
Mobile Wound Professionals LLCGroup PAC ID 8325578800, 3 clinicians

Practice addresses (Care Compare)

Frisco, TX 75036
Phone (972) 657-0157

6012 Timber Creek LN
Dallas, TX 75248-2135
Phone (972) 338-4070

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Visiting Physician LLC CurrentSince Mar 3, 2026 Accepting new patients
Mobile Wound Professionals LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

18383 Preston Rd
Ste 202
Dallas, TX 75252
Phone (469) 546-5539

Organizations & group practices 2

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": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1235801630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17290 PRESTON RD STE 206",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752524028",
            "telephone_number": "972-846-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17290 PRESTON RD STE 206",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752524028",
            "telephone_number": "972-846-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVINS",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1056063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.