Individual provider Active NPI

Courtney Lee Flanders, APRN-CNP

  • Family Nurse Practitioner
  • Independence, OH
National Provider Identifier
1487135232
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
023458 Issued in OH
Practice address
6100 Rockside Woods Blvd N Ste 425
Independence, OH 44131-2340
Phone
(216) 643-2780
Fax
(216) 524-0111
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 023458 OH Primary

Addresses

Primary practice location

6100 Rockside Woods Blvd N Ste 425
Independence, OH 44131-2340

Mailing address

1260 Westfield Dr
Maumee, OH 43537-2730
Phone (419) 388-5195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180918002258 OH Practitioner - Nurse Practitioner 8022369834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023458OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Surgical Wound Care, Inc. CurrentSince Aug 20, 2018 Accepting new patients

Locations

6100 Rockside Woods Blvd N
Ste 425
Independence, OH 44131

7148 West Blvd
Youngstown, OH 44512
Phone (330) 530-4038

Organizations & group practices 1

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1487135232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 WESTFIELD DR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435372730",
            "telephone_number": "419-388-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 ROCKSIDE WOODS BLVD N STE 425",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312340",
            "telephone_number": "216-643-2780",
            "fax_number": "216-524-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANDERS",
        "first_name": "COURTNEY",
        "middle_name": "LEE",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "023458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.