Individual provider Active NPI

Courtney Blackwell Isom, PHARM.D.

  • Pharmacist
  • Greensboro, NC
National Provider Identifier
1043474851
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20244 Issued in NC
Practice address
201 E Wendover Ave
Greensboro, NC 27401-1205
Phone
(336) 832-3631
Fax
(336) 832-3632
NPI assigned
Jul 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20244 NC Primary
Pharmacist 183500000X RPH024324 GA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0070-00329 NC

Addresses

Primary practice location

201 E Wendover Ave
Greensboro, NC 27401-1205

Mailing address

201 E Wendover Ave
Greensboro, NC 27401-1205
Phone (336) 832-3631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH024324GAMDPharmacist
20244NCMDPharmacist
0070-00329NCMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1043474851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011205",
            "telephone_number": "336-832-3631",
            "fax_number": "336-832-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011205",
            "telephone_number": "336-832-3631",
            "fax_number": "336-832-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISOM",
        "first_name": "COURTNEY",
        "middle_name": "BLACKWELL",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "20244",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH024324",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NC",
            "license": "0070-00329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.