Individual provider Active NPI

Courtney Ellen Halista, M.D.

  • Family Medicine Physician
  • Powell, TN
National Provider Identifier
1417337965
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
64835 Issued in TN
Practice address
4565 Market Bell Way
Powell, TN 37849
Phone
(865) 374-3450
Fax
(865) 374-1146
NPI assigned
May 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 29530 NE
Family Medicine Physician 207Q00000X 64835 TN Primary

Addresses

Primary practice location

4565 Market Bell Way
Powell, TN 37849

Mailing address

4565 Market Bell Way
Powell, TN 37849
Phone (865) 374-3450

Other identifiers 1

IdentifierTypeStateIssuer
Q076530MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address halista.courtney.ellen@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220615000703 TN Practitioner - Family Practice 1456628494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

4565 Market Bell Way
Powell, TN 37849-2004
Phone (865) 374-3450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.41 of 100Reported as group
Quality
77.64
Promoting interoperability
100
Improvement activities
40
Cost
80.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of TN, LLC Single Specialty CurrentSince Apr 1, 2023 Accepting new patients
Covenant Medical Group, Inc. Single Specialty CurrentSince Aug 1, 2025 Accepting new patients
Covenant Medical Group, Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

391 Wallace Rd
Nashville, TN 37211
Phone (615) 332-6253

2300 Patterson St
#M
Nashville, TN 37203

Interoperability endpoints

  • Direct secure messaging: courtney.halista@hca1.eclinicaldirectplus.com
  • Direct secure messaging: halista.courtney.ellen@covenanthealth.cernerdirect.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1432944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1417337965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4565 MARKET BELL WAY",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "37849",
            "telephone_number": "865-374-3450",
            "fax_number": "865-374-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 MARKET BELL WAY",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "37849",
            "telephone_number": "865-374-3450",
            "fax_number": "865-374-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALISTA",
        "first_name": "COURTNEY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-30",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "29530",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "64835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q076530",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "halista.courtney.ellen@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "4565 Market Bell Way",
            "city": "Powell",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Powell, TN

Sources for this page

Verify at the official NPI Registry.