Active NPI
Courtney Jayne Walin, RN, BSN, DNS-CT
- Registered Nurse
- Saint John, IN
National Provider Identifier
1548928146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 28250383A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 041444046 | IL | MD | Registered Nurse |
| 28250383A | IN | MD | Registered 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.