Active NPI
Courtney Lynn Donaldson, PTA
- Physical Therapy Assistant
- Andover, MA
National Provider Identifier
1881862910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1324
- Practice address
- 200 Brickstone SQ Ste 301
Andover, MA 01810-1429 - Phone
- (978) 474-7500
- NPI assigned
- Feb 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1324 | WV | Primary |
Addresses
Primary practice location
200 Brickstone SQ Ste 301
Andover, MA 01810-1429
Mailing address
Wishing Well Health Center
1539 Country Club Road
Fairmont, WV 26554
Phone (304) 366-9100
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Elder Care Physician Services LLC | Past | 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.
-
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- Warwick, RI
- NPI 1194774943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394582400000",
"number": "1881862910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WISHING WELL HEALTH CENTER",
"address_2": "1539 COUNTRY CLUB ROAD",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "26554",
"telephone_number": "304-366-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 BRICKSTONE SQ STE 301",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018101429",
"telephone_number": "978-474-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONALDSON",
"first_name": "COURTNEY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-12",
"last_updated": "2014-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WV",
"license": "1324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.