Individual provider Active NPI

Courtney Simmons Markwalter, ANP

  • Adult Health Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1447410741
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5004004 Issued in NC
Practice address
1010 Bethesda CT
Winston Salem, NC 27103-3019
Phone
(336) 277-8800
Fax
(336) 277-8850
NPI assigned
Jun 11, 2008
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5004004 NC Primary
Nurse Practitioner 363L00000X 5004004 NC

Addresses

Primary practice location

1010 Bethesda CT
Winston Salem, NC 27103-3019

Mailing address

PO Box 75216
Charlotte, NC 28275-0216
Phone (336) 718-7080

Other identifiers 1

IdentifierTypeStateIssuer
7005692MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmarkwalter154681@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20081001000043 NC Practitioner - Nurse Practitioner 9638247836 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1213 Lexington Ave
Suite B
Thomasville, NC 27360-3416
Phone (336) 481-1950

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Thomasville Medical Center, LLC CurrentSince Mar 1, 2022 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Mar 1, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Apr 1, 2011 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2016 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2016 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Mar 1, 2022 Accepting new patients
Novant Health Rowan Medical Center LLC Current Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince Mar 1, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Apr 1, 2011 Accepting new patients
Novant Health Thomasville Medical Center LLC Past Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

276 Old Mocksville Rd
Ste 800
Statesville, NC 28625
Phone (704) 873-5150

1213 Lexington Ave
#B
Thomasville, NC 27360
Phone (336) 249-6632

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

1010 Bethesda Ct
Winston Salem, NC 27103
Phone (336) 277-6000

175 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 718-1006

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Organizations & group practices 12

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.

Hospital & facility affiliations 2

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1447410741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282750216",
            "telephone_number": "336-718-7080",
            "fax_number": "336-718-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 BETHESDA CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033019",
            "telephone_number": "336-277-8800",
            "fax_number": "336-277-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKWALTER",
        "first_name": "COURTNEY",
        "middle_name": "SIMMONS",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5004004",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005692",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmarkwalter154681@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1010 Bethesda Ct",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.