MRS. COURTNEY ANN PROVINE CRNP
NPI 1497153472
Nurse Practitioner - Acute Care in Philadelphia, PA
About Mrs. Courtney Ann Provine Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. COURTNEY ANN PROVINE CRNP (NPI 1497153472) is an individual acute care provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP021617) and active in the NPI registry since December 2014. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 6
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Courtney Ann Provine Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Courtney Provine reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Philadelphia, PA 19104
- Reassigned Medicare billing, Pennsylvania enrollment
- 364 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Courtney Provine's NPI number?
The NPI number for Courtney Provine is 1497153472. It was assigned to this individual provider in the NPPES registry on December 8, 2014. The provider is also known as Miss Courtney Ann Burwell Crnp.
Where is Courtney Provine located?
Courtney Provine practices at 3400 Civic Center Blvd 2 South, Philadelphia, PA 19104. The listed phone number is (215) 615-0718.
What is Courtney Provine's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Courtney Provine enrolled in Medicare?
Yes. Courtney Provine is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Courtney Provine's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Courtney Provine reassigns Medicare benefits to University Of Penn-Medical Group (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Courtney Provine's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Courtney Provine was last updated on November 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Courtney Ann Provine, CRNP · NPI 1497153472
Acute Care physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since December 8, 2014.
## Identity
- **NPI:** 1497153472 (Entity type: Individual)
- **Enumerated:** December 8, 2014
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** SP021617 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 3400 CIVIC CENTER BLVD, 2 SOUTH, Philadelphia, PA 19104
- **Phone:** (215) 615-0718 · **Fax:** (215) 349-8309
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Of Penn-Medical Group (NPI 1871981985, Philadelphia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 15, 2021
- **Other identifiers:** Other 4324295 (PA); Medicaid 1029886820001 (PA); Other 30218673 (PA); and 3 more
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Source: [NPI Profile](https://npiprofile.com/npi/1497153472) · Data from the CMS NPPES public registry.