Individual provider Active NPI

Madeleine Amelie Bordelon

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1578036935
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1289985 Issued in TX
Practice address
1714 Redwing Bluff Dr
Houston, TX 77009-2466
Phone
(337) 654-8491
NPI assigned
Jan 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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 1289985 TX Primary

Addresses

Primary practice location

1714 Redwing Bluff Dr
Houston, TX 77009-2466

Mailing address

1714 Redwing Bluff Dr
Houston, TX 77009-2466
Phone (337) 654-8491

Other practice location 1

6621 Fannin St
Houston, TX 77030-2358
Phone (832) 833-0403

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
1289985TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1578036935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 REDWING BLUFF DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770092466",
            "telephone_number": "337-654-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 REDWING BLUFF DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770092466",
            "telephone_number": "337-654-8491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6621 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302358",
            "country_code": "US",
            "telephone_number": "832-833-0403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "MADELEINE",
        "middle_name": "AMELIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1289985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.