Individual provider Active NPI

Courtney Jayne Walin, RN, BSN, DNS-CT

  • Registered Nurse
  • Saint John, IN
National Provider Identifier
1548928146
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28250383A Issued in IN
Practice address
10820 Park PL
Saint John, IN 46373-8630
Phone
(219) 240-9278
NPI assigned
Dec 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041444046 IL
Registered Nurse 163W00000X 28250383A IN Primary

Addresses

Primary practice location

10820 Park PL
Saint John, IN 46373-8630

Mailing address

10820 Park PL
Saint John, IN 46373-8630
Phone (219) 240-9278

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041444046ILMDRegistered Nurse
28250383AINMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1548928146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10820 PARK PL",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738630",
            "telephone_number": "219-240-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10820 PARK PL",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738630",
            "telephone_number": "219-240-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALIN",
        "first_name": "COURTNEY",
        "middle_name": "JAYNE",
        "credential": "RN, BSN, DNS-CT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041444046",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28250383A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint John, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.