Individual provider Active NPI

Cortney Parrish Bourkard, NP

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1750139762
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-077911 Issued in AL
Practice address
4370 W Main St
Dothan, AL 36305-1056
Phone
(334) 794-5000
Fax
(334) 615-7202
NPI assigned
May 7, 2024
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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 1-077911 AL Primary

Addresses

Primary practice location

4370 W Main St
Dothan, AL 36305-1056

Mailing address

4370 W Main St
Dothan, AL 36305-4000
Phone (334) 794-5000

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
I20240807003055 AL Practitioner - Nurse Practitioner 6002353018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wiregrass Clinic LLCGroup PAC ID 2860662491, 69 clinicians

Practice addresses (Care Compare)

108 Medical Dr
Dothan, AL 36303-6902
Phone (334) 944-7041

4300 W Main St
Dothan, AL 36305-1058

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-077911ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wiregrass Clinic LLC Family CurrentSince Sep 3, 2024 Accepting new patients

Locations

108 Medical Dr
Dothan, AL 36303
Phone (334) 793-9567

4300 W Main St
Ste 21
Dothan, AL 36305
Phone (334) 699-7900

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

Interoperability endpoints

  • Direct secure messaging: cortney.bourkard.1@3326.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1750139762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054000",
            "telephone_number": "334-794-5000",
            "fax_number": "334-615-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051056",
            "telephone_number": "334-794-5000",
            "fax_number": "334-615-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURKARD",
        "first_name": "CORTNEY",
        "middle_name": "PARRISH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-077911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.