Lawrence Bourdeau, DPT, ATC, CSCS, OTC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

18051 Issued in MA

Practice address

1820 Turnpike St Ste 200
Off-Season Sports & Physical Therapy
North Andover, MA 01845-6327

Phone

(978) 688-6181

Fax

(978) 688-5120

NPI assigned

Jan 2, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Off-Season Sports and Physical Therapy, IncGroup PAC ID 6507050416, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Off-Season Sports & Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • North Andover, MA
  • NPI 1902127913
  Medicare reassignment Care Compare group Authorized official
• Greendale Physical Therapy, LLC

  • Physical Therapist
  • Shrewsbury, MA
  • NPI 1053316182
  NPD (past)
• Shea Sports Chiropractic, LLC

  • Sports Physician Chiropractor
  • North Andover, MA
  • NPI 1104164102
  NPD (past)

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1659556355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 TURNPIKE ST STE 200",
            "address_2": "OFF-SEASON SPORTS & PHYSICAL THERAPY",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456327",
            "telephone_number": "978-688-6181",
            "fax_number": "978-688-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 TURNPIKE ST STE 200",
            "address_2": "OFF-SEASON SPORTS & PHYSICAL THERAPY",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456327",
            "telephone_number": "978-688-6181",
            "fax_number": "978-688-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDEAU",
        "first_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "DPT, ATC, CSCS, OTC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-02",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18051",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "1845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Booth, NP
• Nancy Boshar
• Margo Bossom, DPT
• Samantha Lynn Boucher, M.S.
• William L Bourassa, D.M.D.
• Gillian Bowdidge, MS CCC-SLP
• Winifred Bowersox
• Charli Bradshaw
• Alexis Bel Brandon
• Nicole Brennan, DPT

• Physical Therapist in North Andover, MA
• Providers in North Andover, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.