Individual provider Active NPI

Madison Lynn Mailloux, PT, DPT

  • Physical Therapist
  • Johnston, RI
National Provider Identifier
1518797356
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT03872 Issued in RI
Practice address
1539 Atwood Ave
Johnston, RI 02919-3262
Phone
(401) 351-0515
NPI assigned
Aug 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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 PT03872 RI Primary

Addresses

Primary practice location

1539 Atwood Ave
Johnston, RI 02919-3262

Mailing address

29 Arthur St
Warwick, RI 02888-1311
Phone (518) 588-7736

Other names 1

  • Madison Lynn Fancher Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909000244 RI Practitioner - Physical Therapist in Private Practice 6507306321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pappas Physical Therapy LLCGroup PAC ID 2567708233, 80 clinicians

Practice addresses (Care Compare)

1100 Reservoir Ave
Cranston, RI 02910-5121
Phone (401) 785-3334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pappas Physical Therapy LLC Physical Therapist CurrentSince Aug 6, 2024 Accepting new patients
Pappas Physical Therapy LLC CurrentSince Aug 6, 2024 Accepting new patients

Locations

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

1100 Reservoir Ave
Cranston, RI 02910
Phone (401) 785-1016

1539 Atwood Ave
Johnston, RI 02919
Phone (401) 272-3410

Organizations & group practices 2

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": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1518797356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 ARTHUR ST",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028881311",
            "telephone_number": "518-588-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 ATWOOD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193262",
            "telephone_number": "401-351-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAILLOUX",
        "first_name": "MADISON",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT03872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "FANCHER",
            "middle_name": "LYNN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.