Kourtney Green, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71005675A Issued in IN

Practice address

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631

Phone

(260) 483-9081

Fax

(260) 483-9196

NPI assigned

Jul 15, 2014

Last updated

Jul 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, MO, OH, KY, VA, NC6 enrollments

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 6

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians

Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians

Eventus Wholehealth Midwest IncGroup PAC ID 4183040470, 120 clinicians

Eventus WH Southeast, LLCGroup PAC ID 5496294456, 241 clinicians

Eventus Premier Healthcare LLCGroup PAC ID 6305381013, 105 clinicians

Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Eventus WH Mid-Atlantic Care LLCGroup PAC ID 8921534744, 89 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Eventus Ecs, Inc

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1073353496

  KY, OH

  Medicare reassignment Care Compare group NPD
• Eventus Wholehealth Midwest Inc

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1386252757

  KY, Nurse Practitioner, OH

  Medicare reassignment Care Compare group NPD
• Extended Care Specialists, Inc

  • Adult Medicine Physician
  • Merrillville, IN
  • NPI 1134146079

  KY, Nurse Practitioner, OH

  Medicare reassignment Care Compare group NPD
• Eventus Premier Healthcare LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Midlothian, VA
  • NPI 1437998309

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Eventus WH Mid-Atlantic Care LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Midlothian, VA
  • NPI 1063253490

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Eventus WH Southeast, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Charlotte, NC
  • NPI 1487494811

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Eventus Wholehealth, PLLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1548759392

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Eventus Ecs - Kentucky, PLLC

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1396563276

  IN

  Medicare reassignment NPD
• Eventus Ecs - Ohio LLC

  • Nurse Practitioner
  • Hilliard, OH
  • NPI 1972321842
  Medicare reassignment NPD
• Eventus Value Care, LLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1013680503
  Medicare reassignment NPD
• Eventus WH Mid-Atlantic, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Midlothian, VA
  • NPI 1700627130

  Nurse Practitioner

  Medicare reassignment NPD
• Eventus WH Midwest Care, LLC

  • Nurse Practitioner
  • Concord, NC
  • NPI 1588481717

  IN, KY

  Medicare reassignment NPD

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1972910602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392552",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519500",
            "telephone_number": "260-483-9081",
            "fax_number": "260-483-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154631",
            "telephone_number": "260-483-9081",
            "fax_number": "260-483-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KOURTNEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2013011851",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005675A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Green
• Janisha Green, RBT
• Jayla Green
• Jessica Green
• Kathryn Green
• Stephanie Green
• Summer Green, RN
• Tanya Laurette Green, MSW
• Marc Greenberg, MD
• Joseph A Greenlee III, M. D.

• Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.