Individual provider Active NPI

Courtney Schinner, RDN

  • Pediatric Nutrition Registered Dietitian
  • Sierra Vista, AZ
National Provider Identifier
1972110948
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
86049806 Issued in AZ
Practice address
155 Calle Portal Ste 700
Sierra Vista, AZ 85635-2973
Phone
(520) 450-0203
Fax
(520) 364-4261
NPI assigned
Sep 24, 2020
Last updated
Sep 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X 86049806 AZ Primary

Addresses

Primary practice location

155 Calle Portal Ste 700
Sierra Vista, AZ 85635-2973

Mailing address

1205 N F Ave
Douglas, AZ 85607-1920
Phone (520) 364-6852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201007000801 AZ Practitioner - Registered Dietitian Or Nutrition Professional 8325467533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86049806AZMDPediatric Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Chiricahua Community Health Centers, Inc CurrentSince Feb 27, 2025 Accepting new patients
Chiricahua Community Health Centers, Inc Current Accepting new patients
Chiricahua Community Health Centers, Inc Past Accepting new patients

Locations

335 S Ocotillo St
Benson, AZ 85602
Phone (520) 326-4811

108 Arizona St
Bisbee, AZ 85603
Phone (520) 432-3309

1100 N F Ave
Douglas, AZ 85607
Phone (520) 364-3285

1111 N F Ave
Douglas, AZ 85607
Phone (520) 364-6860

1151 E 16th St
Douglas, AZ 85607
Phone (520) 364-5437

1205 N F Ave
Douglas, AZ 85607
Phone (520) 364-6852

815 E 15th St
Douglas, AZ 85607
Phone (520) 364-5437

10566 N Highway 191
Elfrida, AZ 85610
Phone (520) 642-2222

155 Calle Portal
Ste 300
Sierra Vista, AZ 85635
Phone (520) 458-6331

155 Calle Portal
Ste 700
Sierra Vista, AZ 85635
Phone (520) 459-0203

4755 Campus Dr
Sierra Vista, AZ 85635
Phone (520) 226-3020

77 Calle Portal
Ste C240
Sierra Vista, AZ 85635
Phone (520) 335-6271

251 W Rex Allen Dr
Willcox, AZ 85643

Organizations & group practices 3

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": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1972110948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-6852",
            "fax_number": "520-364-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CALLE PORTAL STE 700",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352973",
            "telephone_number": "520-450-0203",
            "fax_number": "520-364-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHINNER",
        "first_name": "COURTNEY",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "AZ",
            "license": "86049806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.