Active NPI
Courtney-Maree Heynen, CNM
- Advanced Practice Midwife
- Sioux Falls, SD
National Provider Identifier
1952308397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- CM000065
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202I429644 | Other | GA | MEDICARE PTAN |
| 000972749C | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN160603 | GA | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera McKennan | Current | Accepting new patients | |
| St. Francis Physician Practices LLC | Current | Accepting new patients | |
| St Francis Physician Practices LLC | Current | 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
- courtney.heynen@avera.sdhealthlink.net
- 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sioux Falls, SD
- NPI 1699009944
-
- Family Medicine Physician
- Columbus, GA
- NPI 1326749417
-
- Diagnostic Radiology Physician
- Columbus, GA
- NPI 1033584479
-
- Gastroenterology Physician
- Columbus, GA
- NPI 1609655646
-
- Family Medicine Physician
- Sioux Falls, SD
- NPI 1376575514
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.