COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN) – Registered Dietitian, NPI 1205357282

COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN) is a healthcare provider. based in Naperville, Illinois. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials MS, RDN, LDN. They hold a License No. 164.005319 (IL). The NPI Number for COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN) is 1205357282

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN)
NPI
1205357282
Phone
(708) 250-5381
Address
1109 CATHERINE AVE
Enumeration Date
29 June 2017
Last Update Date
16 April 2021

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
6309862800
Graduation Year
2014 (12 years ago)
PAC ID
3072884592
Group Practice PAC ID
4183126261
Professional Enrollment ID
I20170802000922
Address ID
IL601943550SC25XXXRDXX400
Telehealth
Yes

Contacts

Secure Messaging
courtney.southwood.1@380.direct.athenahealth.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Other namesUpdated within 12 months

311 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in IL

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Provider Addresses for COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN)

  • 1109, Catherine Avenue, Kings Terrace, Naperville, DuPage County, Illinois, 60540, United States

    NAPERVILLE, IL 605405601

    Phone: (708) 250-5381

    Type: Mailing

  • 460 QUAIL RIDGE DR

    WESTMONT, IL 605596145

    Phone: (630) 986-2800

    Type: Mailing

  • 460, Quail Ridge Drive, Westmont, DuPage County, Illinois, 60559, United States

    WESTMONT, IL 605596145

    Phone: (630) 986-2800

    Fax: (630) 986-2440

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-08-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170802000922IRegistered Dietitian Or Nutrition ProfessionalILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60540)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183126261View full group profile
NameSpecialtyState
Nurse PractitionerIL
Family PracticeIL
Registered Dietitian Or Nutrition ProfessionalIL
Family PracticeIL
Registered Dietitian Or Nutrition ProfessionalIL
Registered Dietitian Or Nutrition ProfessionalIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerWI
Nurse PractitionerIL

Reviews

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Frequently asked questions

What NPI should I save for COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN)?
Save NPI 1205357282 if you need a stable reference for COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN).
Does this profile mean COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN) is currently active?
Yes — COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN) appears active in the national provider directory.
What kind of provider is COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN)?
The page reflects Registered Dietitian for COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN). Clinical services aligned with this taxonomy classification.
Does COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN) practice in Illinois?
You will see Naperville, Illinois on file for COURTNEY RULYNN SOUTHWOOD (MS, RDN, LDN) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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