Individual provider Active NPI

Jennifer Courtouise, FNP

  • Family Nurse Practitioner
  • Washington, MO
National Provider Identifier
1265140263
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014024343 Issued in MO
Practice address
851 E 5TH St Ste 108
Washington, MO 63090-3128
Phone
(636) 861-7870
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2014024343 MO Primary

Addresses

Primary practice location

851 E 5TH St Ste 108
Washington, MO 63090-3128

Mailing address

383 McPherson Rd
Leasburg, MO 65535-8165
Phone (314) 856-8053

Other names 1

  • Jennifer Gumpenberger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230123001290 MO Practitioner - Nurse Practitioner 8224409610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

1326 S Service W Rd
Suite 20
Sullivan, MO 63080-2306
Phone (573) 468-3555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014024343MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Nov 13, 2023 Accepting new patients
Mercy Clinic East Communities Family Current Accepting new patients
Mercy Clinic East Communities CurrentSince Nov 13, 2023 Accepting new patients
Mercy Clinic Surgical Specialists, LLC CurrentSince Dec 11, 2022 Accepting new patients

Locations

300 Winding Woods Dr
Ste 206
O Fallon, MO 63366
Phone (636) 239-8097

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 260A
Saint Louis, MO 63141
Phone (314) 251-4772

1326 S Service Rd W
Ste 20
Sullivan, MO 63080
Phone (573) 468-3555

1326 S Service Rd W
#20
Sullivan, MO 63080
Phone (573) 468-3555

1326 S Service Rd W
Ste 30
Sullivan, MO 63080
Phone (314) 543-5999

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

851 E 5th St
Ste 108
Washington, MO 63090
Phone (636) 239-4144

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1265140263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 MCPHERSON RD",
            "city": "LEASBURG",
            "state": "MO",
            "postal_code": "655358165",
            "telephone_number": "314-856-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 E 5TH ST STE 108",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903128",
            "telephone_number": "636-861-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTOUISE",
        "first_name": "JENNIFER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014024343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GUMPENBERGER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.