Individual provider Active NPI

Courtney Lyn Vadala, DPT

  • Physical Therapist
  • Burlington, MA
National Provider Identifier
1629235817
Registry record updated Aug 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18068 Issued in MA
Practice address
35A Winn St
Burlington, MA 01803-4730
Phone
(781) 272-5151
NPI assigned
May 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 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 18068 MA Primary

Addresses

Primary practice location

35A Winn St
Burlington, MA 01803-4730

Mailing address

35A Winn St
Burlington, MA 01803-4730
Phone (781) 272-5151

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
18068MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Lifestyles Inc. Physical Therapist PastSince Jan 2, 2002 Accepting new patients

Organizations & group practices 1

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": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1629235817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35A WINN ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034730",
            "telephone_number": "781-272-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35A WINN ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034730",
            "telephone_number": "781-272-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADALA",
        "first_name": "COURTNEY",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.