Courtney Rayne Mitchell, CFNP

Primary specialty

SpecialistTaxonomy code 174400000X

License

R852899 Issued in MS

Practice address

124 Grandeur Dr
Brandon, MS 39042-5015

Phone

(601) 824-3823

NPI assigned

Aug 20, 2006

Last updated

Mar 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  MS

  Medicare reassignment NPD
• Mississippi Rheumatology and Osteoporosis Center PLLC

  • Rheumatology Physician
  • Flowood, MS
  • NPI 1275062648
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1811002785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 GRANDEUR DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390425015",
            "telephone_number": "601-824-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 GRANDEUR DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390425015",
            "telephone_number": "601-824-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "COURTNEY",
        "middle_name": "RAYNE",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "R852899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08484019",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CFNP CERTIFICATE NUMBER",
            "identifier": "R852899",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mississippi State Department of Health
• Mississippi State Department of Health
• Mississippi State Department of Health
• Mississippi State Department of Health
• Mississippi Transit Care, LLC
• Martha Davidson Mitchell
• Toya R Mitchell
• Mobile Health Solutions Inc
• Frances H Mobley, LCSW
• Malori Michelle Molaison, BA

• Specialist in Brandon, MS
• Providers in Brandon, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.