Individual provider Active NPI

Courtney Dawn Matney, FNP

  • Family Nurse Practitioner
  • Clinton Township, MI
National Provider Identifier
1528926839
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704431834 Issued in MI
Practice address
21360 Cass Ave
Clinton Township, MI 48036-1482
Phone
(276) 494-5051
NPI assigned
Jan 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 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 4704431834 MI Primary

Addresses

Primary practice location

21360 Cass Ave
Clinton Township, MI 48036-1482

Mailing address

35306 Phillip Judson Dr
Clinton Township, MI 48035-2488
Phone (276) 494-5051

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
I20260423000650 MI Practitioner - Nurse Practitioner 3678040094

Care Compare profile

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

Practice addresses (Care Compare)

21360 Cass Ave
Clinton Township, MI 48036-1450

35306 Phillip Judson Dr
Clinton Township, MI 48035-2488

PO Box
Suite 532
Mount Clemens, MI 48046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704431834MIMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1528926839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35306 PHILLIP JUDSON DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480352488",
            "telephone_number": "276-494-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21360 CASS AVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480361482",
            "telephone_number": "276-494-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATNEY",
        "first_name": "COURTNEY",
        "middle_name": "DAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704431834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.