Active NPI
Renee K Courtney, NP
- Nurse Practitioner
- Pontiac, MI
National Provider Identifier
1487632071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704212791
- Practice address
- 44405 Woodward Ave
Outcomes Management
Pontiac, MI 48341-5023 - Phone
- (248) 858-3061
- Fax
- (248) 858-6022
- NPI assigned
- Jan 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704212791 | MI | Primary |
Addresses
Primary practice location
44405 Woodward Ave
Outcomes Management
Pontiac, MI 48341-5023
Mailing address
44405 Woodward Ave
Outcomes Management
Pontiac, MI 48341-5023
Phone (248) 858-3061
Other names 1
- Renee Lynette Kolodziejski
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704212791 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SJMH Medical Practice-SMHC | Current | Accepting new patients | |
| SJMH Medical Practice-SMHC | Nurse Practitioner | Current | Accepting new patients |
Locations
15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300
20555 Victor Pkwy
Stop 3A
Livonia, MI 48152
44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000
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.
-
- Internal Medicine Physician
- Pontiac, MI
- NPI 1346284684
Nurse Practitioner
-
- Urgent Care Clinic/Center
- Waterford, MI
- NPI 1366644551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317772800000",
"number": "1487632071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"address_2": "OUTCOMES MANAGEMENT",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-858-3061",
"fax_number": "248-858-6022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"address_2": "OUTCOMES MANAGEMENT",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-858-3061",
"fax_number": "248-858-6022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COURTNEY",
"first_name": "RENEE",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-04",
"last_updated": "2011-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704212791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RENEE",
"last_name": "KOLODZIEJSKI",
"middle_name": "LYNETTE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.