Kourtney Wallick, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT02767 Issued in RI

Practice address

91 Main St Ste 122
Warren, RI 02885-4437

Phone

(401) 289-2999

NPI assigned

Nov 22, 2014

Last updated

Dec 23, 2021By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

80.9 of 100Reported as group

Quality

79.21

Improvement activities

40

Cost

74.46

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Silver Fern Practice, LLC

  dba Highbar

  • Physical Therapist
  • Smithfield, RI
  • NPI 1013583426
  NPD
• Silver Fern Practice, LLC

  dba Highbar

  • Physical Therapist
  • Providence, RI
  • NPI 1851472914
  NPD

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

{
    "created_epoch": "1416614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1750788527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ STE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MAIN ST STE 122",
            "city": "WARREN",
            "state": "RI",
            "postal_code": "028854437",
            "telephone_number": "401-289-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLICK",
        "first_name": "KOURTNEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-22",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhumi Upadhyay, PA-C
• Van Amberg Family Chiropractic, LLC
• David Jehring Vanamberg, DC
• Jonathan Bruce Vane, D.M.D.
• Robert Gilbert Vaughn Jr., O.D.
• Warren Dental Associates Inc
• Warren Family Practice Associates Inc
• Warren Family Practice Associates, Inc.
• Warren Operations Ri LLC (Warren Center)
• Samantha Welchman, DPT

• Physical Therapist in Warren, RI
• Providers in Warren, RI by specialty
• Physical Therapist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.