Courtney Racquel Mathis, MSN, ARNP, WHNP-BC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

APRN9434446 Issued in FL

Practice address

2000 Fowler Grove Blvd
# 3
Winter Garden, FL 34787-5050

Phone

(407) 303-1380

Fax

(407) 303-1385

NPI assigned

Oct 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southeast Urogyn LLCGroup PAC ID 7517197718, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

71.89 of 100Reported as group

Quality

49.43

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: courtney.mathis.1@30135.direct.athenahealth.com

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.

• Southeast Urogyn LLC

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Jackson, MS
  • NPI 1548513617
  Medicare reassignment Care Compare group NPD
• North Sunflower Medical Center

  • Hospitalist Physician
  • Ruleville, MS
  • NPI 1013128644
  NPD (past)
• Ovation Womens Wellness LLC

  • Gynecology Physician
  • Madison, MS
  • NPI 1548688310
  NPD (past)

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1477005122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FOWLER GROVE BLVD",
            "address_2": "# 3",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "34787",
            "telephone_number": "407-303-1380",
            "fax_number": "407-303-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 FOWLER GROVE BLVD",
            "address_2": "# 3",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875050",
            "telephone_number": "407-303-1380",
            "fax_number": "407-303-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "COURTNEY",
        "middle_name": "RACQUEL",
        "credential": "MSN, ARNP, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MS",
            "license": "903706",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MS",
            "license": "903706",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "APRN9434446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Reyes LMHC LLC
• Flavia Moraes Marzullo
• Makayla Maelyn Massey
• Stefania Massi, RMHCI
• Katrina N Mastrola
• Roderick Mathis
• Ruth Esther Matos, MD
• Victor W Matthews, M.D.
• Maureen Sawh, OD, PLC
• Lovell Leonard Mayle, MD

• Women's Health Nurse Practitioner in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Women's Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.