Individual provider Active NPI

Courtney L Burrus, WHNP-BC

  • Women's Health Nurse Practitioner
  • Mooresville, IN
National Provider Identifier
1336515428
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
71005655A Issued in IN
Practice address
1199 Hadley Rd Ste 102
Mooresville, IN 46158-1788
Phone
(317) 584-3454
Fax
(877) 245-5768
NPI assigned
Aug 12, 2015
Last updated
Dec 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 71005655A IN Primary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 28192069A IN

Addresses

Primary practice location

1199 Hadley Rd Ste 102
Mooresville, IN 46158-1788

Mailing address

11595 N Meridian St Ste 375
Carmel, IN 46032-3950
Phone (317) 575-7304

Other identifiers 1

IdentifierTypeStateIssuer
71005655AOtherININDIANA PROFESSIONAL LICENSING AGENCY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160127000574 IN Practitioner - Nurse Practitioner 2769785625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8051 S Emerson Ave
400 OBGYN of Indiana South
Indianapolis, IN 46237-8633
Phone (317) 865-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71005655AINMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Hills OB-GYN Associates LLC Women's Health CurrentSince Jan 4, 2022 Accepting new patients
Seven Hills OB-GYN Associates, LLC Women's Health CurrentSince Jan 4, 2022 Accepting new patients
Obstetrics & Gynecology of Indiana, LLC Past Accepting new patients

Locations

11405 Pennsylvania St
Ste 260
Carmel, IN 46032
Phone (317) 334-5718

11595 N Meridian St
Ste 375
Carmel, IN 46032
Phone (317) 575-7304

8051 S Emerson Ave
Ste 400
Indianapolis, IN 46237
Phone (317) 865-3600

1199 Hadley Rd
Ste 102
Mooresville, IN 46158
Phone (317) 584-3454

1205 Hadley Rd
Ste 120
Mooresville, IN 46158
Phone (317) 584-3454

6866 W Stonegate Dr
Ste 102
Zionsville, IN 46077
Phone (317) 415-1000

Interoperability endpoints

  • Direct secure messaging: courtney.burrus@axia.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1336515428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11595 N MERIDIAN ST STE 375",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323950",
            "telephone_number": "317-575-7304",
            "fax_number": "317-575-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 HADLEY RD STE 102",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461581788",
            "telephone_number": "317-584-3454",
            "fax_number": "877-245-5768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRUS",
        "first_name": "COURTNEY",
        "middle_name": "L",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "71005655A",
            "primary": true
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "IN",
            "license": "28192069A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA PROFESSIONAL  LICENSING AGENCY",
            "identifier": "71005655A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, IN

Sources for this page

Verify at the official NPI Registry.