Individual provider Active NPI

Courtney Marie Vance, MD

  • Obstetrics & Gynecology Physician
  • Tallahassee, FL
National Provider Identifier
1528529708
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME157061 Issued in FL
Practice address
2770 Capital Medical Blvd
Tallahassee, FL 32308-8417
Phone
(850) 391-3880
Fax
(833) 450-6214
NPI assigned
Mar 28, 2019
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME157061 FL Primary
Obstetrics & Gynecology Physician 207V00000X TRN29432 FL

Addresses

Primary practice location

2770 Capital Medical Blvd
Tallahassee, FL 32308-8417

Mailing address

3621 Molly Pitcher CT
Tallahassee, FL 32308-4000
Phone (210) 837-0584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108003835 FL Practitioner - Obstetrics/Gynecology 6204360530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Texas Tech University Health Science Center School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diana Health FL, PAGroup PAC ID 5092253245, 33 clinicians

Practice addresses (Care Compare)

2770 Capital Medical Blvd
Suite 220
Tallahassee, FL 32308-8417
Phone (850) 391-3880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME157061FLMDObstetrics & Gynecology Physician
TRN29432FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diana Health FL P.a. Obstetrics & Gynecology CurrentSince Oct 28, 2024 Accepting new patients

Locations

1046 Mar Walt Dr
Ste 200
Fort Walton Beach, FL 32547
Phone (850) 243-2229

2770 Capital Medical Blvd
Ste 220
Tallahassee, FL 32308
Phone (850) 391-3880

Interoperability endpoints

  • Direct secure messaging: courtney.vance.1@23211.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23211/brand/1/csg/21/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1528529708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 MOLLY PITCHER CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084000",
            "telephone_number": "210-837-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323088417",
            "telephone_number": "850-391-3880",
            "fax_number": "833-450-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME157061",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "TRN29432",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.