Individual provider Active NPI

Courtney Elise Holman, CRNP

  • Acute Care Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1730729435
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-157853 Issued in AL
Practice address
801 Princeton Ave SW Ste 707
Birmingham, AL 35211-1309
Phone
(251) 214-1412
Fax
(205) 780-7775
NPI assigned
Jan 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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 1-157853 AL Primary

Addresses

Primary practice location

801 Princeton Ave SW Ste 707
Birmingham, AL 35211-1309

Mailing address

801 Princeton Ave SW Ste 707
Birmingham, AL 35211-1309

Other identifiers 2

IdentifierTypeStateIssuer
303780MedicaidAL
1-157853OtherALCRNP LICENSE

Other names 1

  • Courtney Johns Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20200526002800 AL Practitioner - Nurse Practitioner 2769803907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

833 Princeton Ave SW
Birmingham, AL 35211-1323

Hospital & facility affiliations

  • Princeton Baptist Medical Center Hospital, Birmingham, AL, CCN 010103
  • University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033
  • Walker Baptist Medical Center Hospital, Jasper, AL, CCN 010089

Merit-based Incentive Payment System (MIPS)

Final score
92.56 of 100Reported as group
Quality
93.68
Promoting interoperability
100
Improvement activities
40
Cost
73.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-157853ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology , PC CurrentSince May 4, 2023 Accepting new patients
Nephrology Medical Associates of Georgia LLC PastSince Jan 12, 2020 Accepting new patients

Locations

801 Princeton Ave SW
Ste 707
Birmingham, AL 35211
Phone (205) 780-4330

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

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 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": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1730729435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 PRINCETON AVE SW STE 707",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 PRINCETON AVE SW STE 707",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111309",
            "telephone_number": "251-214-1412",
            "fax_number": "205-780-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "COURTNEY",
        "middle_name": "ELISE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-157853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303780",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP LICENSE",
            "identifier": "1-157853",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "JOHNS",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.