Individual provider Active NPI

Courtney L Buck, RD,LDN

  • Registered Dietitian
  • Alpharetta, GA
National Provider Identifier
1912374992
Registry record updated Feb 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD004300 Issued in GA
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

Updated by the provider on Feb 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151124002458 GA Practitioner - Registered Dietitian Or Nutrition Professional 4082914932 Reassigns benefits to 1 organization

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
Harmony Nutrition LLCGroup PAC ID 7315371127, 6 clinicians

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

LicenseStateTypeSpecialty
LD004300GAMDRegistered Dietitian
L005326NCMDRegistered Dietitian
LDN0000003764TNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Worksite Wellness Partners Dietitian, Registered CurrentSince Feb 26, 2023 Accepting new patients
Harmony Nutrition LLC Dietitian, Registered CurrentSince May 25, 2023 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.

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.

Verify at the official NPI Registry.