Individual provider Active NPI

Renee K Courtney, NP

  • Nurse Practitioner
  • Pontiac, MI
National Provider Identifier
1487632071
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704212791 Issued in MI
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

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040622001379 MI Practitioner - Nurse Practitioner 2062497134 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704212791MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC CurrentSince Feb 3, 2025 Accepting new patients
SJMH Medical Practice-SMHC Nurse Practitioner CurrentSince Feb 3, 2025 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.

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

Verify at the official NPI Registry.