Active NPI
Courtney Davis, PHARMD
- Pharmacist
- Southlake, TX
National Provider Identifier
1225637952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 56305
- Practice address
- 2110 E Southlake Blvd
Southlake, TX 76092-6506 - Phone
- (817) 421-7487
- NPI assigned
- Oct 23, 2020
- 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 | 56305 | TX | Primary |
Addresses
Primary practice location
2110 E Southlake Blvd
Southlake, TX 76092-6506
Mailing address
1440 Eagleton LN
Northlake, TX 76226-1804
Phone (575) 496-0350
Other names 1
- Courtney Hawkins
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | kroger |
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 |
|---|---|---|---|
| 56305 | TX | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas L P | Past | Accepting new patients | |
| Kroger Texas LP | 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.
-
- Community/Retail Pharmacy
- Southlake, TX
- NPI 1336212950
-
- Community/Retail Pharmacy
- Fort Worth, TX
- NPI 1407747439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603411200000",
"number": "1225637952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 EAGLETON LN",
"city": "NORTHLAKE",
"state": "TX",
"postal_code": "762261804",
"telephone_number": "575-496-0350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 E SOUTHLAKE BLVD",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926506",
"telephone_number": "817-421-7487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "COURTNEY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-23",
"last_updated": "2020-10-23",
"certification_date": "2020-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "TX",
"license": "56305",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "kroger",
"affiliation": "N",
"address_1": "2110 E Southlake Blvd",
"city": "Southlake",
"state": "TX",
"country_code": "US",
"postal_code": "760926506",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "COURTNEY",
"last_name": "HAWKINS",
"credential": "PHARMD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.