Active NPI
Courtney L Bork, MD
- Family Medicine Physician
- Rice Lake, WI
National Provider Identifier
1255912937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD-52909
- Practice address
- 1700 W Stout St
Rice Lake, WI 54868-5000 - Phone
- (715) 236-8100
- NPI assigned
- Apr 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 81162 | WI | |
| Family Medicine Physician | 207Q00000X | MD-52909 | IA | Primary |
Addresses
Primary practice location
1700 W Stout St
Rice Lake, WI 54868-5000
Mailing address
1700 W Stout St
Rice Lake, WI 54868-5000
Phone (715) 236-8100
Other practice location 1
1201 3rd Ave SE
Cedar Rapids, IA 52403-4009
Phone (319) 730-7300
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@marshfieldclinichealthsystem.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250927000191 | WI | Practitioner - Family Practice | 3072917632 | Reassigns benefits to 9 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakeview Medical Center Inc of Rice Lake
Practice addresses (Care Compare)
1700 W Stout St
Rice Lake, WI 54868-5000
Phone (715) 236-6133
Hospital & facility affiliations
- Marshfield Medical Center - Rice Lake
- Marshfield Medical Center - Ladysmith
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-52909 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Memorial Hospital Inc | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Beaver Dam Community Hospitals Inc | Current | Accepting new patients | |
| Flambeau Hospital Inc | Current | Accepting new patients | |
| Memorial Hospital Inc | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Marshfield Clinic Inc | Current | Accepting new patients | |
| Lakeview Medical Center Inc of Rice Lake | Current | Accepting new patients | |
| Flambeau Hospital Inc | Current | Accepting new patients | |
| Beaver Dam Community Hospitals Inc | Current | Accepting new patients | |
| St Luke'S Methodist Hospital | Past | Accepting new patients | |
| Eastern Iowa Health Center | Family Medicine | Past | Accepting new patients |
Locations
705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090
3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200
1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111
1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399
N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101
1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133
Interoperability endpoints
- him@marshfieldclinichealthsystem.cernerdirect.com
- cbork521961@direct.gundersenhealth.org
Organizations & group practices 21
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.
-
- Rural Acute Care Hospital
- Rice Lake, WI
- NPI 1154415024
-
- Home Health Agency
- Rice Lake, WI
- NPI 1326139049
-
- Dialysis Equipment & Supplies (DME)
- Rice Lake, WI
- NPI 1356827638
-
- Rural Health Clinic/Center
- Hayward, WI
- NPI 1639766694
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Rice Lake, WI
- NPI 1154415024
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758067200000",
"number": "1255912937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 W STOUT ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548685000",
"telephone_number": "715-236-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 W STOUT ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548685000",
"telephone_number": "715-236-8100"
}
],
"practiceLocations": [
{
"address_1": "1201 3rd Ave SE",
"address_purpose": "LOCATION",
"city": "Cedar Rapids",
"state": "IA",
"postal_code": "524034009",
"country_code": "US",
"telephone_number": "319-730-7300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BORK",
"first_name": "COURTNEY",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-15",
"last_updated": "2025-09-17",
"certification_date": "2025-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "81162",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "MD-52909",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
"affiliation": "N",
"address_1": "1700 W Stout St",
"city": "Rice Lake",
"state": "WI",
"country_code": "US",
"postal_code": "548685000",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Rice Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.