Courtney Holden Shoemaker, RDCS (AE, PE)

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

812 S 7TH St
Goshen, IN 46526-4017

Phone

(574) 238-8092

NPI assigned

Jun 19, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Michelle Holden Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1386329308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S 7TH ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264017",
            "telephone_number": "574-238-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S 7TH ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264017",
            "telephone_number": "574-238-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "COURTNEY",
        "middle_name": "HOLDEN",
        "credential": "RDCS (AE, PE)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "HOLDEN",
            "middle_name": "MICHELLE",
            "credential": "RDCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Student in an Organized Health Care Education/Training Program in Goshen, IN
• Providers in Goshen, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.