KOURTNEY GREEN FNP
NPI 1972910602
Nurse Practitioner in Fort Wayne, IN

Q: What is Kourtney Green's NPI number?

The NPI number for Kourtney Green is 1972910602. It was assigned to this individual provider in the NPPES registry on July 15, 2014.

Q: What is Kourtney Green's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kourtney Green was last updated on July 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since July 15, 2014PECOS Enrolled

3512 STELLHORN RD, FORT WAYNE, IN 46815(260) 483-9081(260) 483-9196 Get Directions Write a Review

NPPES record last updated: July 16, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 16, 2020, Jan 17, 2018 (2 updates tracked since 2018).

On this page

About Kourtney Green Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOURTNEY GREEN FNP (NPI 1972910602) is an individual nurse practitioner in Fort Wayne, Indiana, licensed in Indiana (71005675A) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1972910602

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKOURTNEY GREENCredential: FNP

Location Address3512 STELLHORN RDFort Wayne, IN 46815-4631

Mailing AddressPo Box 392552Pittsburgh, PA 15251-9500 · (260) 483-9081 · Fax (260) 483-9196

Phone(260) 483-9081

Fax(260) 483-9196

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJuly 15, 2014

Last NPPES UpdateJuly 16, 20202 updates tracked since enumeration

NPPES CertifiedJuly 16, 2020

✔ NPI 1972910602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Licenses✔ Licensed in IN · 71005675A✔ Licensed in MO · 2013011851

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

3512 STELLHORN RD, Fort Wayne, IN 46815

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kourtney Green Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6406163070

PECOS Enrollment IDI20150915000105, I20250108002598, I20250108003081, I20250422000613, I20250422001942

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kourtney Green reassigns Medicare billing to 16 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Eventus Ecs, Inc

108 mi

Nurse Practitioner

150 W MARKET ST STE 400
Indianapolis, IN 46204

Reassigned Medicare billing, Indiana, Kentucky and Ohio enrollments
210 clinicians in this Medicare group

NPI 1073353496 (855) 743-2247

Extended Care Specialists, Inc

118 mi

Adult Medicine

8398 MISSISSIPPI ST FL 2
Merrillville, IN 46410

Reassigned Medicare billing, Indiana, Kentucky and Ohio enrollments
233 clinicians in this Medicare group

NPI 1134146079 (855) 743-2247

Eventus Ecs - Ohio LLC

127 mi

Nurse Practitioner

3958 BROWN PARK DR STE D
Hilliard, OH 43026

Reassigned Medicare billing, Indiana and Ohio enrollments
150 clinicians in this Medicare group

NPI 1972321842 (855) 743-2247

Eventus Wholehealth Midwest Inc

138 mi

Family Medicine

2100 MIDWAY ST # 3722
Columbus, IN 47201

Reassigned Medicare billing, Indiana, Kentucky and Ohio enrollments
129 clinicians in this Medicare group

NPI 1386252757 (260) 483-9081

Eventus Ecs - Kentucky, PLLC

215 mi

Nurse Practitioner

828 LANE ALLEN RD STE 219
Lexington, KY 40504

Reassigned Medicare billing, Indiana and Kentucky enrollments
135 clinicians in this Medicare group

NPI 1396563276 (855) 743-2247

Provider Profile

415 mi

Podiatrist

2600 KANELL BLVD
Poplar Bluff, MO 63901

Reassigned Medicare billing, Missouri enrollment
8 clinicians in this Medicare group

NPI 1508838566 (573) 785-4546

Eventus Value Care, LLC

464 mi

Family Medicine

101 CABARRUS AVE E STE 200
Concord, NC 28025

Reassigned Medicare billing, North Carolina enrollment
187 clinicians in this Medicare group

NPI 1013680503 (855) 743-2247

Eventus Wh Midwest Care, LLC

464 mi

Nurse Practitioner

101 CABARRUS AVE E STE 100
Concord, NC 28025

Reassigned Medicare billing, Indiana and Kentucky enrollments
139 clinicians in this Medicare group

NPI 1588481717 (855) 743-2247

Eventus Wholehealth Aco LLC

464 mi

Geriatric Medicine

101 CABARRUS AVE E STE 200
Concord, NC 28025

Reassigned Medicare billing, Virginia enrollment
53 clinicians in this Medicare group

NPI 1023796307 (855) 743-2247

Eventus Wholehealth, PLLC

464 mi

Family Medicine

101 CABARRUS AVE E STE 200
Concord, NC 28025

Reassigned Medicare billing, North Carolina enrollment
312 clinicians in this Medicare group

NPI 1548759392 (855) 743-2247

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

620 services213 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

281 services84 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

239 services59 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

193 services88 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

110 services55 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

71 services33 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

55 services50 patients

Psychiatric diagnostic evaluation with medical services 90792

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

53 services53 patients

Psychiatric diagnostic evaluation with medical services 90792

30 services30 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

27 services20 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

20 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46815 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MRS. LHYRA DAWIS MAYORALGO PT

Contractor