Individual provider Active NPI

Courtney Rose Lepak, APNP

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1790513844
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15629-33 Issued in WI
Practice address
725 S Webster Ave Ste 201
Green Bay, WI 54301-3500
Phone
(920) 430-7100
Fax
(920) 430-7114
NPI assigned
Jul 22, 2024
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 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 15629-33 WI Primary

Addresses

Primary practice location

725 S Webster Ave Ste 201
Green Bay, WI 54301-3500

Mailing address

744 S Webster Ave
Medical Staff Services
Green Bay, WI 54301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240911001544 MI Practitioner - Nurse Practitioner 0648710137 Reassigns benefits to 1 organization
I20240930001565 WI Practitioner - Nurse Practitioner 0648710137 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, shared by 10 NPIs, 685 clinicians

Practice addresses (Care Compare)

212 E B St
Bellin Health
Iron Mountain, MI 49801-3411
Phone (906) 776-9040

725 S Webster Ave
Green Bay, WI 54301-3504
Phone (920) 433-3456

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Aug 13, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Aug 13, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Aug 13, 2024 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Aug 13, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

610 S Lincoln Rd
Escanaba, MI 49829
Phone (906) 786-6488

212 E B St
Iron Mountain, MI 49801
Phone (906) 774-2990

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

725 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-3655

725 S Webster Ave
Ste 201
Green Bay, WI 54301
Phone (920) 430-1700

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: clepak917061@direct.emplifyhealth.org

Organizations & group practices 8

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": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1790513844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WEBSTER AVE STE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013500",
            "telephone_number": "920-430-7100",
            "fax_number": "920-430-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPAK",
        "first_name": "COURTNEY",
        "middle_name": "ROSE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "15629-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.