Individual provider Active NPI

Courtney-Maree Heynen, CNM

  • Advanced Practice Midwife
  • Sioux Falls, SD
National Provider Identifier
1952308397
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CM000065 Issued in SD
Practice address
1417 S. Cliff Ave.
Ste. 401
Sioux Falls, SD 57105-1064
Phone
(605) 322-8920
Fax
(605) 322-8919
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN160603 GA
Advanced Practice Midwife 367A00000X CM000065 SD Primary

Addresses

Primary practice location

1417 S. Cliff Ave.
Ste. 401
Sioux Falls, SD 57105-1064

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7510

Other identifiers 2

IdentifierTypeStateIssuer
202I429644OtherGAMEDICARE PTAN
000972749CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090619000205 GA Practitioner - Certified Nurse Midwife (CNM) 5496806119 Reassigns benefits to 1 organization
I20160801002476 SD Practitioner - Certified Nurse Midwife (CNM) 5496806119 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN160603GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Current Accepting new patients
St. Francis Physician Practices LLC CurrentSince Jan 1, 2016 Accepting new patients
St Francis Physician Practices LLC CurrentSince Jan 1, 2016 Accepting new patients
St. Francis Physician Practices LLC Current Accepting new patients
Avera McKennan Past Accepting new patients

Locations

2300 Manchester Expy
Ste H202
Columbus, GA 31904
Phone (706) 320-3090

2300 Manchester Expy
Ste A002
Columbus, GA 31904
Phone (706) 320-3203

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

Interoperability endpoints

  • Direct secure messaging: courtney.heynen@avera.sdhealthlink.net
  • Direct secure messaging: courtney.heynen@sfhga.gadirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1952308397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86370",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186370",
            "telephone_number": "605-322-7510",
            "fax_number": "605-322-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 S. CLIFF AVE.",
            "address_2": "STE. 401",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051064",
            "telephone_number": "605-322-8920",
            "fax_number": "605-322-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYNEN",
        "first_name": "COURTNEY-MAREE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN160603",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "SD",
            "license": "CM000065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I429644",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000972749C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.