Individual provider Active NPI

Courtney Danielle Levy, MMS, PA-C, RD, CNSC

  • Physician Assistant
  • West Bloomfield, MI
National Provider Identifier
1962034884
Registry record updated Sep 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010680 Issued in MI
Practice address
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone
(800) 653-6568
Fax
(248) 325-1551
NPI assigned
Feb 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164007950 IL
Physician Assistant 363A00000X 5601010680 MI Primary

Addresses

Primary practice location

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Mailing address

1 Ford PL
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone (734) 712-3456

Other practice location 2

36475 Five Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-4800

Other names 1

  • Courtney Danielle Gullett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210727003368 MI Practitioner - Physician Assistant 0749683845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 583-9125

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Hospital & facility affiliations

  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
164007950ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Physician Assistant CurrentSince Aug 1, 2024 Accepting new patients
Iha Health Services Corporation CurrentSince Aug 1, 2021 Accepting new patients
Henry Ford Health System CurrentSince Aug 1, 2024 Accepting new patients
Iha Health Service Corporation CurrentSince Aug 1, 2021 Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Detroit, MI 48202
Phone (313) 874-4118

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Interoperability endpoints

  • Direct secure messaging: cgullett1289121@direct.trinity-health.org
  • Direct secure messaging: cgullett1037149@direct.hfhs.org

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.

Hospital & facility affiliations 1

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": "1581120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1962034884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "800-653-6568",
            "fax_number": "248-325-1551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 McAuley Dr",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971051",
            "country_code": "US",
            "telephone_number": "734-712-3456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36475 Five Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481541971",
            "country_code": "US",
            "telephone_number": "734-655-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVY",
        "first_name": "COURTNEY",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "MMS, PA-C, RD, CNSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-08",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164007950",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "GULLETT",
            "middle_name": "DANIELLE",
            "credential": "MMS, PA-C, RD, CNSC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.