Active NPI
Courtney Anne Wilson, RPH
- Pharmacist
- Bristol, CT
National Provider Identifier
1376287748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8680
- Practice address
- 377 Village St
Bristol, CT 06010-8062 - Phone
- (860) 944-4420
- NPI assigned
- Apr 22, 2022
- 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 | 8680 | CT | Primary |
Addresses
Primary practice location
377 Village St
Bristol, CT 06010-8062
Mailing address
377 Village St
Bristol, CT 06010-8062
Phone (860) 944-4420
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8680 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651536000000",
"number": "1376287748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "377 VILLAGE ST",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060108062",
"telephone_number": "860-944-4420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "377 VILLAGE ST",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060108062",
"telephone_number": "860-944-4420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "COURTNEY",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-22",
"last_updated": "2022-05-03",
"certification_date": "2022-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "8680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.