John Courtney, BS, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

013082-01 Issued in NY

Practice address

4140 Old Washington Rd
Waldorf, MD 20602-3221

Phone

(301) 645-2813

NPI assigned

Jan 7, 2022

Last updated

Jan 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1215698501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SOUTHWOOD DR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142231053",
            "telephone_number": "716-480-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 OLD WASHINGTON RD",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023221",
            "telephone_number": "301-645-2813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 6th St S",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337053720",
            "country_code": "US",
            "telephone_number": "716-480-2513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2611 Jones Ave",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810042650",
            "country_code": "US",
            "telephone_number": "716-480-2513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COURTNEY",
        "first_name": "JOHN",
        "credential": "BS, PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-07",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PTA31465",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "PTA.0015136",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "013082-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "PTA31496",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "013082-01",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.courtney@kindred.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3030 6th St S",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337053720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Physical Medicine & Rehabilitation Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.