Individual provider Active NPI

Courtney Renea Ervin

  • Acute Care Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1558957951
Registry record updated Dec 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
124140 Issued in AR
Practice address
9501 Baptist Health Dr
Little Rock, AR 72205-6225
Phone
(501) 202-7000
NPI assigned
Dec 19, 2020
Last updated
Dec 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 124140 AR Primary

Addresses

Primary practice location

9501 Baptist Health Dr
Little Rock, AR 72205-6225

Mailing address

13 Reservoir Heights Dr
Little Rock, AR 72227-5758
Phone (501) 859-7399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20210108001171 AR Practitioner - Nurse Practitioner 0345653499 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Jan 4, 2021 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince May 24, 2024 Accepting new patients
Arkansas Health Group CurrentSince Jan 4, 2021 Accepting new patients
Arkansas Health Group PastSince Dec 27, 2020 Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9501 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-7000

9501 Baptist Health Dr
Fl First
Little Rock, AR 72205
Phone (501) 202-7395

3343 Springhill Dr
Ste 2050
North Little Rock, AR 72117
Phone (501) 413-2450

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1608336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608336000000",
    "number": "1558957951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 RESERVOIR HEIGHTS DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722275758",
            "telephone_number": "501-859-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 BAPTIST HEALTH DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056225",
            "telephone_number": "501-202-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "COURTNEY",
        "middle_name": "RENEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-19",
        "last_updated": "2020-12-19",
        "certification_date": "2020-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "124140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.