Active NPI
Courtney Weller, PHARMD
- Pharmacist
- Owasso, OK
National Provider Identifier
1063923712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16121
- Practice address
- 18741 E Red Fox TRL
Owasso, OK 74055-8341 - Phone
- (612) 777-4536
- NPI assigned
- Oct 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16121 | OK | Primary |
Addresses
Primary practice location
18741 E Red Fox TRL
Owasso, OK 74055-8341
Mailing address
519 W El Paso St
Broken Arrow, OK 74012-4044
Phone (918) 340-4656
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16121 | Other | OK | BOARD OF PHARMACY |
Other names 1
- Courtney Tucker
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16121 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oklahoma CVS Pharmacy LLC | Past | Accepting new patients | |
| Oklahoma CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691712000000",
"number": "1063923712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "519 W EL PASO ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740124044",
"telephone_number": "918-340-4656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18741 E RED FOX TRL",
"city": "OWASSO",
"state": "OK",
"postal_code": "740558341",
"telephone_number": "612-777-4536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLER",
"first_name": "COURTNEY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-21",
"last_updated": "2023-08-11",
"certification_date": "2023-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "16121",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "16121",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "COURTNEY",
"last_name": "TUCKER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Owasso, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.