Individual provider Active NPI

Cortni McCall

  • Psychiatric/Mental Health Nurse Practitioner
  • Alamo, TN
National Provider Identifier
1417504010
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
37374 Issued in TN
Practice address
580 W Main St
Alamo, TN 38001-1545
Phone
(731) 394-1145
NPI assigned
Aug 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 37374 TN Primary
Community Health Registered Nurse 163WC1500X 228171 TN

Addresses

Primary practice location

580 W Main St
Alamo, TN 38001-1545

Mailing address

2835 Republican Grove Rd
Atwood, TN 38220-4203
Phone (731) 487-2848

Other practice location 1

1632 Highway 45 Byp
Humboldt, TN 38343-6697
Phone (731) 394-1145

Other practice location 2

213 Herndon Dr
Bells, TN 38006-3654
Phone (731) 394-1145

Other practice location 3

150 Oak Manor Rd
Mc Kenzie, TN 38201-8846
Phone (731) 394-1145

Other practice location 4

220 College St
Puryear, TN 38251-6441
Phone (731) 394-1145

Other practice location 5

1124 N Main St
Dyer, TN 38330-1033
Phone (731) 394-1145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241210001348 TN Practitioner - Nurse Practitioner 6406382753 Reassigns benefits to 2 organizations
I20250612003027 KY Practitioner - Nurse Practitioner 6406382753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

366 S Washington St
Clinton, KY 42031-1324
Phone (731) 394-1145

4128 Old Jackson Rd
Bells, TN 38006-4261
Phone (731) 394-1145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228171TNMDCommunity Health Registered Nurse
37374TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health LLC CurrentSince Oct 24, 2024 Accepting new patients

Locations

366 S Washington St
Clinton, KY 42031
Phone (270) 653-2461

1124 N Main St
Dyer, TN 38330
Phone (731) 692-4545

14510 Highway 79
Mc Kenzie, TN 38201
Phone (731) 352-5317

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1417504010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 REPUBLICAN GROVE RD",
            "city": "ATWOOD",
            "state": "TN",
            "postal_code": "382204203",
            "telephone_number": "731-487-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W MAIN ST",
            "city": "ALAMO",
            "state": "TN",
            "postal_code": "380011545",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1632 Highway 45 Byp",
            "address_purpose": "LOCATION",
            "city": "Humboldt",
            "state": "TN",
            "postal_code": "383436697",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "213 Herndon Dr",
            "address_purpose": "LOCATION",
            "city": "Bells",
            "state": "TN",
            "postal_code": "380063654",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Oak Manor Rd",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382018846",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 College St",
            "address_purpose": "LOCATION",
            "city": "Puryear",
            "state": "TN",
            "postal_code": "382516441",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1124 N Main St",
            "address_purpose": "LOCATION",
            "city": "Dyer",
            "state": "TN",
            "postal_code": "383301033",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCALL",
        "first_name": "CORTNI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "37374",
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TN",
            "license": "228171",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamo, TN

Sources for this page

Verify at the official NPI Registry.