Individual provider Active NPI

Courtney Mitchell, NP-C

  • Family Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1720659204
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011159A Issued in IN
Practice address
3211 W Reddy Way
Bloomington, IN 47403-4066
Phone
(812) 825-0777
NPI assigned
Jul 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71011159A IN Primary

Addresses

Primary practice location

3211 W Reddy Way
Bloomington, IN 47403-4066

Mailing address

3211 W Reddy Way
Bloomington, IN 47403-4066
Phone (812) 825-0777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210623002991 IN Practitioner - Nurse Practitioner 4880095256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monroe Medical Group IncGroup PAC ID 0446576680, 25 clinicians

Practice addresses (Care Compare)

3209 W Reddy Way
Bloomington, IN 47403-4089

3211 W Reddy Way
Bloomington, IN 47403-4066

421 S Landmark Ave
Bloomington, IN 47403-5003
Phone (812) 676-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.71 of 100Reported as group
Quality
56.86
Promoting interoperability
97
Improvement activities
40
Cost
81.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71011159AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Medical Group Inc CurrentSince Jun 29, 2021 Accepting new patients

Locations

3211 W Reddy Way
Bloomington, IN 47403
Phone (812) 825-0777

4011 S Monroe Medical Park Blvd
Bloomington, IN 47403
Phone (812) 825-5777

421 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-4468

Interoperability endpoints

  • Direct secure messaging: courtney.mitchell.1@8479.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8479/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 4

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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1720659204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 W REDDY WAY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034066",
            "telephone_number": "812-825-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 W REDDY WAY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034066",
            "telephone_number": "812-825-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "COURTNEY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011159A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.