Individual provider Active NPI

Courtenay Beckwith Sly, RN

  • General Practice Registered Nurse
  • Bishop, CA
National Provider Identifier
1528515657
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
333194 Issued in CA
Practice address
52 Tu Su Lane
Bishop, CA 93514-8058
Phone
(760) 873-8464
Fax
(760) 873-3935
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 333194 CA Primary

Addresses

Primary practice location

52 Tu Su Lane
Bishop, CA 93514-8058

Mailing address

52 Tu Su Lane
Bishop, CA 93514-8058
Phone (760) 873-8464

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
333194CAMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Toiyabe Indian Health Project, Inc Past Accepting new patients
Toiyabe Indian Health Project, Inc PastSince Jun 11, 2015 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1528515657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 TU SU LANE",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148058",
            "telephone_number": "760-873-8464",
            "fax_number": "760-873-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 TU SU LANE",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148058",
            "telephone_number": "760-873-8464",
            "fax_number": "760-873-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLY",
        "first_name": "COURTENAY",
        "middle_name": "BECKWITH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "333194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.