Individual provider Active NPI

Courtney Violet Vandermay, DPT

  • Physical Therapist
  • Rockwall, TX
National Provider Identifier
1740944925
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1374080 Issued in TX
Practice address
2268 N Lake Shore Dr Ste 106
Rockwall, TX 75087-0280
Phone
(973) 979-6577
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-32248 AZ
Physical Therapist 225100000X 14700 TN
Physical Therapist 225100000X P20807 NC
Physical Therapist 225100000X 40QA02047300 NJ
Physical Therapist 225100000X 26167 MA
Physical Therapist 225100000X 1374080 TX Primary

Addresses

Primary practice location

2268 N Lake Shore Dr Ste 106
Rockwall, TX 75087-0280

Mailing address

93 Lenox Rd
Wayne, NJ 07470-5539
Phone (201) 790-3697

Other practice location 1

13951 W Grand Ave Ste 201
Surprise, AZ 85374-2436
Phone (623) 537-9730

Other practice location 2

333 Irving Ave
Bridgeton, NJ 08302-2123
Phone (856) 575-4500

Other practice location 3

1430 W Sherman Ave Ste 1
Vineland, NJ 08360-6927
Phone (856) 641-7875

Other practice location 4

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26167MAMDPharmacotherapy Pharmacist
LPT-32248AZMDPhysical Therapist
P20807NCMDPhysical Therapist
40QA02047300NJMDPhysical Therapist
14700TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Mar 6, 2023 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Mar 6, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

5129 N Garland Ave
Ste 600
Garland, TX 75040
Phone (469) 838-4072

2268 N Lake Shore Dr
Ste 106
Rockwall, TX 75087
Phone (214) 771-7960

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

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": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1740944925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 LENOX RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705539",
            "telephone_number": "201-790-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 N LAKE SHORE DR STE 106",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750870280",
            "telephone_number": "973-979-6577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13951 W Grand Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853742436",
            "country_code": "US",
            "telephone_number": "623-537-9730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Irving Ave",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "NJ",
            "postal_code": "083022123",
            "country_code": "US",
            "telephone_number": "856-575-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1430 W Sherman Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083606927",
            "country_code": "US",
            "telephone_number": "856-641-7875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155400",
            "country_code": "US",
            "telephone_number": "617-667-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERMAY",
        "first_name": "COURTNEY",
        "middle_name": "VIOLET",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32248",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14700",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20807",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02047300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "26167",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1374080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.