Individual provider Active NPI

Courtney Rose Borischak, RN

  • Registered Nurse
  • Ebensburg, PA
National Provider Identifier
1437634755
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN687469 Issued in PA
Practice address
429 Manor Dr
Ebensburg, PA 15931-4917
Phone
(814) 472-6060
Fax
(814) 472-1293
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN687469 PA Primary

Addresses

Primary practice location

429 Manor Dr
Ebensburg, PA 15931-4917

Mailing address

404 S Caroline St
Ebensburg, PA 15931-2085
Phone (814) 243-1224

Other identifiers 1

IdentifierTypeStateIssuer
163W00000XMedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN687469PAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1437634755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 S CAROLINE ST",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159312085",
            "telephone_number": "814-243-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 MANOR DR",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314917",
            "telephone_number": "814-472-6060",
            "fax_number": "814-472-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORISCHAK",
        "first_name": "COURTNEY",
        "middle_name": "ROSE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN687469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163W00000X",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.