Courtney Locklear Woodside, RD LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L004388 Issued in NC

Practice address

17 Pumpkin PL
Durham, NC 27703-6097

Phone

(910) 638-5266

NPI assigned

Mar 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Rose Locklear Former name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1457827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457827200000",
    "number": "1255792602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 PUMPKIN PL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277036097",
            "telephone_number": "910-638-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 PUMPKIN PL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277036097",
            "telephone_number": "910-638-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODSIDE",
        "first_name": "COURTNEY",
        "middle_name": "LOCKLEAR",
        "credential": "RD LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-13",
        "last_updated": "2016-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "LOCKLEAR",
            "middle_name": "ROSE",
            "credential": "RD LDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Derek Michael Woodruff
• Mary Margaret Woodruff
• Christopher Wildrick Woods, MD, MPH
• Jalynn Simone Woods
• Suzanne Woods, M.D.
• Aubrey Michelle Woodson, MSN, RN, CPNP-PC
• Dominic Dean Woodson, DO
• Meredith Woodson, DPT
• Christopher J Woodward, PHARM.D.
• Julia Taylor Woodward, PH.D

• Registered Dietitian in Durham, NC
• Providers in Durham, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.