Individual provider Active NPI

Courtney Ann Mulroy

  • Psychiatric/Mental Health Nurse Practitioner
  • Cranston, RI
National Provider Identifier
1831795475
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN03328 Issued in RI
Practice address
1170 Pontiac Ave
Cranston, RI 02920-7944
Phone
(401) 837-9937
Fax
(401) 296-3995
NPI assigned
Dec 9, 2020
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN64647 RI
Registered Nurse 163W00000X RN2301482 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN03328 RI Primary

Addresses

Primary practice location

1170 Pontiac Ave
Cranston, RI 02920-7944

Mailing address

420 Scrabbletown Rd Ste a
North Kingstown, RI 02852-3638
Phone (401) 408-9235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20230320002110 RI Practitioner - Nurse Practitioner 8820462500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South County Psychiatry LLCGroup PAC ID 4880021658, 28 clinicians

Practice addresses (Care Compare)

1170 Pontiac Ave
Cranston, RI 02920-7944
Phone (401) 268-5333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2301482MAMDRegistered Nurse
RN64647RIMDRegistered Nurse
APRN03328RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South County Psychiatry LLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

1170 Pontiac Ave
Cranston, RI 02920
Phone (401) 500-0424

420 Scrabbletown Rd
Ste A
North Kingstown, RI 02852
Phone (401) 268-5333

47 Danielson Pike
North Scituate, RI 02857
Phone (401) 258-5419

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.

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1831795475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SCRABBLETOWN RD STE A",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028523638",
            "telephone_number": "401-408-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 PONTIAC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029207944",
            "telephone_number": "401-837-9937",
            "fax_number": "401-296-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULROY",
        "first_name": "COURTNEY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN64647",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2301482",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN03328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.