Courtney Sumida, DNP, AGPCNP-BC, CSFA

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209.026121 Issued in IL

Practice address

1905 E Huebbe Pkwy
Beloit, WI 53511-1896

Phone

(608) 364-2230

Fax

(608) 363-7394

NPI assigned

May 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beloit Health System IncGroup PAC ID 8224947858, 138 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beloit Health System Hospital, Beloit, WI, CCN 520100

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Beloit Health System Inc

  • General Practice Physician
  • Beloit, WI
  • NPI 1679616361
  Medicare reassignment Care Compare group NPD
• Beloit Clinic, S.C.

  • Internal Medicine Physician
  • Beloit, WI
  • NPI 1548345887
  NPD
• Beloit Health System, Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Beloit, WI
  • NPI 1568677417
  NPD
• Beloit Health System, Inc

  • Family Medicine Physician
  • Janesville, WI
  • NPI 1407999337
  NPD (past)

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

• Beloit Health System Inc

  • General Acute Care Hospital
  • Beloit, WI
  • NPI 1982780094
  Care Compare affiliation

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1306583778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E HUEBBE PKWY",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111896",
            "telephone_number": "608-364-2230",
            "fax_number": "608-363-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 E HUEBBE PKWY",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111896",
            "telephone_number": "608-364-2230",
            "fax_number": "608-363-7394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5605 E Rockton Rd",
            "address_purpose": "LOCATION",
            "city": "Roscoe",
            "state": "IL",
            "postal_code": "610737601",
            "country_code": "US",
            "telephone_number": "815-525-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMIDA",
        "first_name": "COURTNEY",
        "credential": "DNP, AGPCNP-BC, CSFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041442675",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209.026121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christin Strong, APNP
• Rayna Strong, DDS
• Michelle Stroud
• Gregory Stubbe
• Rachelle M. Suchla, OT
• Supportive Hands Healing Minds, LLC
• Ruth C. Taggart, NP
• Hajera Fatima Taher, M.D.
• Janna Sue Tamminga, PT
• Glenn Anthony Tan, M.D.

• Gerontology Nurse Practitioner in Beloit, WI
• Providers in Beloit, WI by specialty
• Gerontology Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.

Verify at the official NPI Registry.