Courtney Drevo, R.D./L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1939 Issued in OK

Practice address

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002

Phone

(580) 354-5671

NPI assigned

Nov 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Davis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Anadarko Indian Health Center

  • Federal Public Health Clinic/Center
  • Anadarko, OK
  • NPI 1881637403
  NPD (past)

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1861822074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073002",
            "telephone_number": "580-354-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073002",
            "telephone_number": "580-354-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREVO",
        "first_name": "COURTNEY",
        "credential": "R.D./L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "DAVIS",
            "credential": "R.D./L.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Lawton, OK
• Providers in Lawton, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; 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.