Individual provider Active NPI

Courtney Marie Iaquinto Guerrant

  • Nurse Practitioner
  • Edina, MN
National Provider Identifier
1548872963
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11338 Issued in MN
Practice address
7380 France Ave S Ste 220
Edina, MN 55435-4537
Phone
(651) 341-4291
NPI assigned
Aug 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201902527RN OR
Pediatric Nurse Practitioner 363LP0200X 2377252 MN
Nurse Practitioner 363L00000X 11338 MN Primary

Addresses

Primary practice location

7380 France Ave S Ste 220
Edina, MN 55435-4537

Mailing address

7380 France Ave S Ste 220
Edina, MN 55435-4537
Phone (651) 341-4291

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csmith1905@email.arizona.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240925003760 MN Practitioner - Nurse Practitioner 6709327190 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201902527RNORMDRegistered Nurse
2377252MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Red Balloon Urgent Care PLLC Pediatrics CurrentSince Sep 1, 2024 Accepting new patients

Locations

7380 France Ave S
Ste 220
Minneapolis, MN 55435
Phone (651) 341-4291

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1548872963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7380 FRANCE AVE S STE 220",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354537",
            "telephone_number": "651-341-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7380 FRANCE AVE S STE 220",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354537",
            "telephone_number": "651-341-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRANT",
        "first_name": "COURTNEY",
        "middle_name": "MARIE IAQUINTO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201902527RN",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "2377252",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "11338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csmith1905@email.arizona.edu",
            "affiliation": "N",
            "endpointDescription": "school",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "22 SE 11th Ave Apt 103",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972141392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.