Individual provider Active NPI

Cory Lynn Marcoux, PT, DPT

  • Physical Therapist
  • Cornish, ME
National Provider Identifier
1972953933
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4623 Issued in ME
Practice address
16 Old Pike Rd
Cornish, ME 04020-3506
Phone
(207) 625-4300
NPI assigned
Jun 20, 2016
Last updated
Jun 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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 PT4623 ME Primary

Addresses

Primary practice location

16 Old Pike Rd
Cornish, ME 04020-3506

Mailing address

902A River Rd
Buxton, ME 04093-3955
Phone (508) 331-9614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160728002377 ME Practitioner - Physical Therapist in Private Practice 0840583753 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of New England, College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reform Physical Therapy IncGroup PAC ID 7214239540, 23 clinicians

Practice addresses (Care Compare)

15 Piper Rd
Scarborough, ME 04074-7575
Phone (207) 762-9255

169 Port Rd
Suite 21
Kennebunk, ME 04043-7754
Phone (207) 204-0679

23 Durham Rd
Suite 101
Freeport, ME 04032-6796
Phone (207) 725-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT4623MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reform Physical Therapy, Inc Physical Therapist CurrentSince Aug 16, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jan 24, 2026 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jan 24, 2026 Accepting new patients
Foothills Physical Therapy, PA Physical Therapist CurrentSince Jun 20, 2016 Accepting new patients
Rivertree Osteopathic Health PC Past Accepting new patients

Locations

190 Pleasant St
Brunswick, ME 04011

16 Old Pike Rd
Cornish, ME 04020
Phone (207) 625-4300

23 Durham Rd
Ste 101
Freeport, ME 04032
Phone (207) 725-4400

169 Port Rd
Ste 1
Kennebunk, ME 04043
Phone (207) 204-0679

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1972953933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902A RIVER RD",
            "city": "BUXTON",
            "state": "ME",
            "postal_code": "040933955",
            "telephone_number": "508-331-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 OLD PIKE RD",
            "city": "CORNISH",
            "state": "ME",
            "postal_code": "040203506",
            "telephone_number": "207-625-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOUX",
        "first_name": "CORY",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT4623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornish, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.