Individual provider Active NPI

Courtney Cuppy

  • Pharmacist
  • Shakopee, MN
National Provider Identifier
1255934634
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
123457 Issued in MN
Practice address
1198 Vierling Dr E
Shakopee, MN 55379-4316
Phone
(952) 445-6344
NPI assigned
Nov 18, 2020
Last updated
Nov 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 123457 MN Primary

Addresses

Primary practice location

1198 Vierling Dr E
Shakopee, MN 55379-4316

Mailing address

1198 Vierling Dr E
Shakopee, MN 55379-4316
Phone (952) 445-6344

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

State licenses

LicenseStateTypeSpecialty
123457MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Supervalu Pharmacies Inc. PastSince Nov 22, 2020 Accepting new patients
Supervalu Pharmacies Inc PastSince Nov 22, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1255934634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1198 VIERLING DR E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553794316",
            "telephone_number": "952-445-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1198 VIERLING DR E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553794316",
            "telephone_number": "952-445-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPPY",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "123457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.

Verify at the official NPI Registry.