Courtney Otts Mantooth, CRNP in Birmingham, AL

Courtney Otts Mantooth, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Birmingham, Alabama. Her current practice location is 801 Princeton Ave Sw Ste 707, Birmingham, Alabama. You can reach out to her office (for appointments etc.) via phone at (205) 780-4330.

Courtney Otts Mantooth is licensed to practice in Alabama (license number 1-150536) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1851866099.

Contact Information

	Courtney Otts Mantooth, CRNP
	801 Princeton Ave Sw Ste 707, Birmingham, AL 35211
	(205) 780-4330
	Not Available

Map and Direction

Provider's Profile

Full Name	Courtney Otts Mantooth
Gender	Female
Speciality	Nurse Practitioner - Family
Location	801 Princeton Ave Sw Ste 707, Birmingham, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1851866099
Provider Enumeration Date: 10/03/2018
Last Update Date: 05/13/2024

Medicare PECOS Information:

PECOS PAC ID: 6507291168
Enrollment ID: I20200109000455

Medical Identifiers

Medical identifiers for Courtney Otts Mantooth such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1851866099	NPI	-	NPPES
1-150536	Other	AL	ALABAMA RN LICENSE
243254	Medicaid	AL
1-150536	Other	AL	CRNP LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	1-150536 (Alabama)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Courtney Otts Mantooth allows following entities to bill medicare on her behalf.

Entity Name	Cardiology P C
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285690776 PECOS PAC ID: 6204723752 Enrollment ID: O20040301000736

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Courtney Otts Mantooth is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Courtney Otts Mantooth, CRNP 801 Princeton Ave Sw Ste 707, Birmingham, AL 35211-1395 Ph: (205) 780-4330	Courtney Otts Mantooth, CRNP 801 Princeton Ave Sw Ste 707, Birmingham, AL 35211 Ph: (205) 780-4330

Reviews and Comments

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Courtney Otts Mantooth, CRNP - Medicare Nurse Practitioner in Birmingham, AL