Individual provider Active NPI

Courtney D Weaver

  • Driver
  • Indianapolis, IN
National Provider Identifier
1407798499
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
415262955 Issued in IN
Practice address
9640 Gull Lake Dr
Indianapolis, IN 46239-6892
Phone
(765) 667-7988
NPI assigned
Apr 8, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 415262955 IN Primary

Addresses

Primary practice location

9640 Gull Lake Dr
Indianapolis, IN 46239-6892

Mailing address

9640 Gull Lake Dr
Indianapolis, IN 46239-6892
Phone (765) 667-7988

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
415262955INMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1407798499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9640 GULL LAKE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462396892",
            "telephone_number": "765-667-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 GULL LAKE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462396892",
            "telephone_number": "765-667-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "COURTNEY",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "IN",
            "license": "415262955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.