Individual provider Active NPI

Lavonne E Couch, PT, ED.D, CSCS

  • Physical Therapist
  • Moorestown, NJ
National Provider Identifier
1235220377
Registry record updated Mar 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00694000 Issued in NJ
Practice address
300 Harper Dr
Moorestown, NJ 08057-3208
Phone
(856) 552-1300
Fax
(856) 552-1308
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015154 PA
Physical Therapist 225100000X 40QA00694000 NJ Primary
Physical Therapist 225100000X J1-0001819 DE

Addresses

Primary practice location

300 Harper Dr
Moorestown, NJ 08057-3208

Mailing address

PO Box 964
Mount Laurel, NJ 08054-0964
Phone (609) 706-6752

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0001819DEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332028800000",
    "number": "1235220377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 964",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080540964",
            "telephone_number": "609-706-6752",
            "fax_number": "856-727-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HARPER DR",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573208",
            "telephone_number": "856-552-1300",
            "fax_number": "856-552-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUCH",
        "first_name": "LAVONNE",
        "middle_name": "E",
        "credential": "PT, ED.D, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015154",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00694000",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0001819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2012; 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.