Active NPI
Courtney E Hannegan, APNP
- Nurse Practitioner
- Madison, WI
National Provider Identifier
1265189302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11509
- Practice address
- 2222 S Park St Ste 210
Madison, WI 53713-2168 - Phone
- (844) 493-1052
- NPI assigned
- Mar 8, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 11509 | WI | Primary |
Addresses
Primary practice location
2222 S Park St Ste 210
Madison, WI 53713-2168
Mailing address
2222 S Park St Ste 210
Madison, WI 53713-2168
Phone (844) 493-1052
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11509 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1265189302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 S PARK ST STE 210",
"city": "MADISON",
"state": "WI",
"postal_code": "537132168",
"telephone_number": "844-493-1052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 S PARK ST STE 210",
"city": "MADISON",
"state": "WI",
"postal_code": "537132168",
"telephone_number": "844-493-1052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNEGAN",
"first_name": "COURTNEY",
"middle_name": "E",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-08",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "11509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.