Individual provider Active NPI

Courtney Alexis Smith, FNP-BC

  • Family Nurse Practitioner
  • Wyandotte, MI
National Provider Identifier
1487454476
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704357661 Issued in MI
Practice address
2300 Biddle Ave
Wyandotte, MI 48192-4650
Phone
(734) 246-5705
NPI assigned
Mar 18, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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 4704357661 MI Primary

Addresses

Primary practice location

2300 Biddle Ave
Wyandotte, MI 48192-4650

Mailing address

2300 Biddle Ave Ste 100
Wyandotte, MI 48192-4650
Phone (734) 246-5705

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2300 Biddle Ave
Suite 100
Wyandotte, MI 48192-4650

8801 Middleton CT
Grosse Ile, MI 48138-1283

Hospital & facility affiliations

  • Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704357661MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fadi Delly, MD PC CurrentSince Mar 24, 2025 Accepting new patients
Ghazwan Atto MD PC PastSince Mar 24, 2025 Accepting new patients

Locations

2300 Biddle Ave
#100
Wyandotte, MI 48192
Phone (734) 246-5705

2300 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-5705

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.

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": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1487454476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BIDDLE AVE STE 100",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924650",
            "telephone_number": "734-246-5705",
            "fax_number": "734-246-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924650",
            "telephone_number": "734-246-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COURTNEY",
        "middle_name": "ALEXIS",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704357661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.