Individual provider Active NPI

Courtney D Dupont, PTA

  • Physical Therapy Assistant
  • Bedford, NH
National Provider Identifier
1538338017
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
0787 Issued in NH
Practice address
25 Ridgewood Rd
Bedford, NH 03110-6510
Phone
(603) 623-8805
NPI assigned
Feb 28, 2008
Last updated
Apr 29, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0787 NH Primary
Physical Therapy Assistant 225200000X 7890 MA

Addresses

Primary practice location

25 Ridgewood Rd
Bedford, NH 03110-6510

Mailing address

25 Ridgewood Rd
Bedford, NH 03110-6510
Phone (603) 623-8805

Other identifiers 2

IdentifierTypeStateIssuer
0787OtherNHPTA LISCENSE
7890OtherMAPTA LISCENSE

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

State licenses

LicenseStateTypeSpecialty
7890MAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1538338017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 RIDGEWOOD RD",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106510",
            "telephone_number": "603-623-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 RIDGEWOOD RD",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106510",
            "telephone_number": "603-623-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPONT",
        "first_name": "COURTNEY",
        "middle_name": "D",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NH",
            "license": "0787",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "7890",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LISCENSE",
            "identifier": "0787",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LISCENSE",
            "identifier": "7890",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.