Individual provider Active NPI

Courtenay E Deane, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Crosby, MN
National Provider Identifier
1720333891
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
62113 Issued in MN
Practice address
320 E Main St
Crosby, MN 56441-1645
Phone
(218) 546-7000
Fax
(218) 546-4400
NPI assigned
Jul 16, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X DO2702 ME
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 62113 MN Primary

Addresses

Primary practice location

320 E Main St
Crosby, MN 56441-1645

Mailing address

320 East Main Street
Crosby, MN 56441
Phone (218) 546-7000

Other practice location 1

21725 Reno Lake Rd
Deerwood, MN 56444-8545
Phone (207) 992-3666

Other identifiers 1

IdentifierTypeStateIssuer
62113OtherMNLICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cdeane378930@excellian.direct.allina.com Direct Cuyuna Regional Medical Center
Direct Messaging Address cdeane378930@excellian.direct.allina.com 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171025002100 MN Practitioner - Osteopathic Manipulative Medicine 2567773666 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2702MEMDNeuromusculoskeletal Medicine & OMM Physician
62113MNMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cuyuna Regional Medical Center Current Accepting new patients

Locations

320 E Main St
Crosby, MN 56441
Phone (218) 546-7000

Interoperability endpoints

  • Direct secure messaging: cdeane378930@excellian.direct.allina.com

Organizations & group practices 2

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720333891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EAST MAIN STREET",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "56441",
            "telephone_number": "218-546-7000",
            "fax_number": "218-546-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E MAIN ST",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411645",
            "telephone_number": "218-546-7000",
            "fax_number": "218-546-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21725 Reno Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Deerwood",
            "state": "MN",
            "postal_code": "564448545",
            "country_code": "US",
            "telephone_number": "207-992-3666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEANE",
        "first_name": "COURTENAY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "DO2702",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MN",
            "license": "62113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "62113",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdeane378930@excellian.direct.allina.com",
            "affiliation": "Y",
            "affiliationName": "Cuyuna Regional Medical Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cdeane378930@excellian.direct.allina.com",
            "address_1": "320 E Main St",
            "city": "Crosby",
            "state": "MN",
            "country_code": "US",
            "postal_code": "564411645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdeane378930@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDA/PDF/TXT",
            "address_1": "320 E Main St",
            "city": "Crosby",
            "state": "MN",
            "country_code": "US",
            "postal_code": "564411645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crosby, MN

Sources for this page

Verify at the official NPI Registry.