Individual provider Active NPI

Courtney Reid Wass-Martineau, MS PT

  • Physical Therapist
  • Brockton, MA
National Provider Identifier
1376771212
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13375 Issued in MA
Practice address
215 Thatcher St
Brockton, MA 02302-3949
Phone
(508) 583-5834
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13375 MA Primary

Addresses

Primary practice location

215 Thatcher St
Brockton, MA 02302-3949

Mailing address

7 Ray Way
East Bridgewater, MA 02333-2573
Phone (508) 456-1005

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
13375MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1376771212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 RAY WAY",
            "city": "EAST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023332573",
            "telephone_number": "508-456-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 THATCHER ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023949",
            "telephone_number": "508-583-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASS-MARTINEAU",
        "first_name": "COURTNEY",
        "middle_name": "REID",
        "name_prefix": "Mrs.",
        "credential": "MS PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "13375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.