Individual provider Active NPI

Courtney Breanne Thompson, ARNP

  • Nurse Practitioner
  • Spencer, IA
National Provider Identifier
1316722366
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A175861 Issued in IA
Practice address
1200 1St Ave E
Spencer, IA 51301-4342
Phone
(712) 264-6198
NPI assigned
Aug 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A175861 IA Primary

Addresses

Primary practice location

1200 1St Ave E
Spencer, IA 51301-4342

Mailing address

113 Parkway Dr
Spencer, IA 51301-5953
Phone (712) 260-4529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20231017002048 IA Practitioner - Nurse Practitioner 1850746405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer Municipal HospitalGroup PAC ID 4183533060, 95 clinicians

Practice addresses (Care Compare)

1200 1St Ave E
Spencer, IA 51301-4330

1200 1St Ave E
Spencer, IA 51301-4342
Phone (712) 264-6198

1200 1St Ave E C
Nwia Bone Joint and Sports Surgeons
Spencer, IA 51301-4342
Phone (712) 262-7511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Municipal Hospital CurrentSince Oct 9, 2023 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital CurrentSince Oct 9, 2023 Accepting new patients
Northwest Iowa Dermatology LLC Past Accepting new patients

Locations

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

1200 1st Ave E
Ste 1
Spencer, IA 51301
Phone (712) 264-6160

Organizations & group practices 5

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 4

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": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1316722366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PARKWAY DR",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513015953",
            "telephone_number": "712-260-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 1ST AVE E",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014342",
            "telephone_number": "712-264-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "COURTNEY",
        "middle_name": "BREANNE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A175861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

Verify at the official NPI Registry.