Active NPI
Courtney Brooke Wilcott, PHARM D
- Pharmacist
- Henderson, NV
National Provider Identifier
1104467422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16828
- Practice address
- 3411 Saint Rose Pkwy
Henderson, NV 89052-4570 - Phone
- (702) 803-7054
- Fax
- (702) 803-7045
- NPI assigned
- Oct 8, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 16828 | NV | Primary |
Addresses
Primary practice location
3411 Saint Rose Pkwy
Henderson, NV 89052-4570
Mailing address
1657 Amador LN
Henderson, NV 89012-3611
Phone (702) 325-8325
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 |
|---|---|---|---|
| 16828 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570492800000",
"number": "1104467422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1657 AMADOR LN",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890123611",
"telephone_number": "702-325-8325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3411 SAINT ROSE PKWY",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890524570",
"telephone_number": "702-803-7054",
"fax_number": "702-803-7045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOTT",
"first_name": "COURTNEY",
"middle_name": "BROOKE",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-08",
"last_updated": "2019-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "16828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.