KOURTNEY LEIGH NYSTROM (NPI# 1740881309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740881309 |
| Entity Type | Individual |
| Full Name | KOURTNEY LEIGH NYSTROM |
| Practice Address |
8118 Corporate Way Ste 212 Mason OH 45040-9560 |
| Practice Telephone | 8779386537 |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2020-11-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
8118 CORPORATE WAY STE 212 |
| City | MASON |
| State | OH |
| Zip Code | 45040-9560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649524422 | Dustin E Blevins | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040 | 2012-11-01 |
| 1023619723 | Ana Milena Hess | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2020-11-08 |
| 1790386191 | Tiffany Michele Frye | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2020-11-03 |
| 1912516246 | Asha Catherine Talib | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2020-07-22 |
| 1477177160 | Jacob Austin Kamm | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2020-05-29 |
| 1447898705 | Darci Gallimore | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2019-12-18 |
| 1841756681 | Samantha Nicole Ingram | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2019-02-18 |
| 1669956058 | Maryem Menad | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2018-09-20 |
| 1124508593 | Jeree Coleman | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2018-08-15 |
| 1245710813 | Stephanie Darlene Rodriguez | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2018-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336633882 | Jarek Beegan | Specialist/Technologist, Other | 8188 Corporate Way, Mason, OH 45040 | 2018-06-19 |
| 1548771439 | Jeanene Gibson | Registered Nurse | 9945 Coventry Court, Mason, OH 45040 | 2017-10-18 |
| 1093249898 | Peace of Mind Care Services, Inc. | Community/Behavioral Health | 5180 Cedar Village Drive, Suite A, Mason, OH 45040 | 2017-04-18 |
| 1477938736 | Justin William Florek | Chiropractor | 6213 Snider Road, Mason, OH 45040 | 2015-07-28 |
| 1730562729 | Alexandra Courts | Physical Therapist | 5267 Joseph Ln, Mason, OH 45040 | 2015-07-08 |
| 1982083531 | Nicole Roether | Specialist/Technologist | 5236 Socialville-foster Road, Mason, OH 45040 | 2015-05-28 |
| 1568849123 | Alissa Marie Conde | Pediatrics | 9560 Children's Drive, Mason, OH 45040 | 2015-05-04 |
| 1205220696 | Elizabeth Barnes | Pain Medicine | 3611 Socialville-foster Rd, Suite 101, Mason, OH 45040 | 2015-03-24 |
| 1669864807 | Lang Truong | Pharmacist | 5542 Red Fox Ct, Mason, OH 45040 | 2015-02-25 |
| 1295133668 | Gregory Carr | Psychologist | 4569 Wesley Ct, Mason, OH 45040 | 2014-12-16 |
| Find all providers in zip 45040 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336633882 | Jarek Beegan | Specialist/Technologist, Other | 8188 Corporate Way, Mason, OH 45040 | 2018-06-19 |
| 1649524422 | Dustin E Blevins | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040 | 2012-11-01 |
| 1023619723 | Ana Milena Hess | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2020-11-08 |
| 1144829474 | Collin Thomas Blevins | Specialist/Technologist, Other | 8118 Corporate Way, Mason, OH 45040-7350 | 2020-10-19 |
| 1245847771 | Maria-jose Rodriguez | Specialist/Technologist, Other | 8118 Corporate Way, Mason, OH 45040-7350 | 2020-09-29 |
| 1912516246 | Asha Catherine Talib | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2020-07-22 |
| 1306454830 | Olivia Hope Starcher | Specialist/Technologist, Other | 8118 Corporate Way, Mason, OH 45040-7350 | 2020-07-21 |
| 1609490143 | Kerriston Wilson | Specialist/Technologist, Other | 8118 Corporate Way, Mason, OH 45040-7350 | 2020-06-01 |
| 1477177160 | Jacob Austin Kamm | Specialist/Technologist, Other | 8118 Corporate Way Ste 212, Mason, OH 45040-9560 | 2020-05-29 |
| 1013542695 | Nicholas A Rechtin | Specialist/Technologist, Other | 8118 Corporate Way, Suite 212, Mason, OH 45040 | 2020-03-04 |
| Find all providers in MASON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.