Active NPI
Courtney L Buck, RD,LDN
- Registered Dietitian
- Alpharetta, GA
National Provider Identifier
1912374992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD004300
- Practice address
- 1802 Abbey CT
Alpharetta, GA 30004-6017 - Phone
- (678) 554-7576
- NPI assigned
- Aug 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LDN0000003764 | TN | |
| Registered Dietitian | 133V00000X | L005326 | NC | |
| Registered Dietitian | 133V00000X | LD004300 | GA | Primary |
Addresses
Primary practice location
1802 Abbey CT
Alpharetta, GA 30004-6017
Mailing address
1802 Abbey CT
Alpharetta, GA 30004-6017
Other names 1
- Courtney Willis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1802 Abbey CT
Alpharetta, GA 30004-6017
Phone (678) 554-7576
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD004300 | GA | MD | Registered Dietitian |
| L005326 | NC | MD | Registered Dietitian |
| LDN0000003764 | TN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Worksite Wellness Partners | Dietitian, Registered | Current | Accepting new patients |
| Harmony Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
| Pinehurst Medical Clinic, Inc. | Past | Accepting new patients |
Locations
1802 Abbey Ct
Alpharetta, GA 30004
Phone (678) 393-8661
Organizations & group practices 3
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.
-
- Clinical Medical Laboratory
- Southern Pines, NC
- NPI 1962509372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677283200000",
"number": "1912374992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 ABBEY CT",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300046017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 ABBEY CT",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300046017",
"telephone_number": "678-554-7576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCK",
"first_name": "COURTNEY",
"middle_name": "L",
"credential": "RD,LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-26",
"last_updated": "2023-02-25",
"certification_date": "2023-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "LDN0000003764",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L005326",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD004300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "COURTNEY",
"last_name": "WILLIS",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Alpharetta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.