Courtney L Madera, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT34934 Issued in FL

Practice address

12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618

Phone

(904) 886-3228

Fax

(904) 485-8876

NPI assigned

Sep 16, 2019

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

• Ms. Courtney L Capobianco Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1245880889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD STE 508",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD STE 508",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238618",
            "telephone_number": "904-886-3228",
            "fax_number": "904-485-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADERA",
        "first_name": "COURTNEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "CAPOBIANCO",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "PT DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen B Maddox, MA
• Lisa Jeanne Maddox
• Supradeep Shree Venkata Madduri
• Colin Mader, DPT
• Jenna Mader
• Vadim Lev Madfis, M.D.
• Harry Madhanagopal, D.O.
• Colleen Madison
• Jade Madison
• Trenton R Madison, MD

• Physical Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.