Individual provider Active NPI

Courtenay Nicole Havers, M.D.

  • Family Medicine Physician
  • Silverdale, WA
National Provider Identifier
1619913100
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00041968 Issued in WA
Practice address
9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502
Phone
(360) 782-3400
Fax
(360) 782-3450
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00041968 WA Primary

Addresses

Primary practice location

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502

Mailing address

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502
Phone (360) 782-3400

Other identifiers 6

IdentifierTypeStateIssuer
169190OtherWALABOR AND INDUSTRIES
1014702MedicaidWA
8359416MedicaidWA
8918BROtherREGENCE BLUESHIELD
P00023573OtherRAILROAD MEDICARE
7405427OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050301000943 WA Practitioner - Family Practice 3870546898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

9398 Ridgetop Blvd NW
Silverdale, WA 98383-8505
Phone (360) 782-3200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00041968WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Family Medicine CurrentSince Sep 3, 2016 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Sep 3, 2016 Accepting new patients

Locations

21 NE Romance Hill Rd
Ste 105
Belfair, WA 98528
Phone (360) 277-2950

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

11307 Bridgeport Way SW
Ste 220A
Lakewood, WA 98499
Phone (253) 985-2733

450 S Kitsap Blvd
Ste 100
Port Orchard, WA 98366
Phone (360) 744-6275

450 S Kitsap Blvd
Ste 250
Port Orchard, WA 98366
Phone (360) 782-3000

19245 7th Ave NE
#O
Poulsbo, WA 98370
Phone (360) 782-3500

2200 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 830-1100

9621 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3300

9398 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3200

9398 Ridgetop Blvd NW
#O
Silverdale, WA 98383
Phone (360) 782-3200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1619913100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502",
            "telephone_number": "360-782-3400",
            "fax_number": "360-782-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502",
            "telephone_number": "360-782-3400",
            "fax_number": "360-782-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERS",
        "first_name": "COURTENAY",
        "middle_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00041968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "169190",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014702",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8359416",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "8918BR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00023573",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7405427",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.