Individual provider Active NPI

Cody Adam Myrick, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1043851801
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09573 Issued in NC
Practice address
5093 University Pkwy
Winston Salem, NC 27106-6085
Phone
(336) 883-0029
NPI assigned
Oct 3, 2019
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 0010-09573 NC
Physician Assistant 363A00000X 0010-09573 NC Primary

Addresses

Primary practice location

5093 University Pkwy
Winston Salem, NC 27106-6085

Mailing address

645 N Main St
High Point, NC 27260-5017
Phone (336) 883-0029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200110002139 NC Practitioner - Physician Assistant 0648605196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bethany Medical CenterGroup PAC ID 4486614575, 71 clinicians

Practice addresses (Care Compare)

3604 Peters CT
High Point, NC 27265-9004
Phone (336) 883-0029

3605 Peters CT
High Point, NC 27265-9004
Phone (336) 883-0029

3610 Peters CT
High Point, NC 27265-9004
Phone (336) 883-0029

3801 W Market St
Greensboro, NC 27407-1301
Phone (336) 883-0026

495 Arbor Hill Rd
Kernersville, NC 27284-3335
Phone (336) 883-0029

507 N Lindsay St
High Point, NC 27262-4303
Phone (336) 883-0029

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.84 of 100Reported as group
Quality
70.27
Promoting interoperability
98
Improvement activities
40
Cost
77.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-09573NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bethany Medical Center PA Family Medicine CurrentSince Oct 24, 2019 Accepting new patients
Bethany Medical Center, PA Family Medicine CurrentSince Oct 24, 2019 Accepting new patients
Bethany Medical Center Current Accepting new patients
Bethany Medical Center, PA Past Accepting new patients
Bethany Medical Center Family Medicine Past Accepting new patients
Bethany Medical Center Family Medicine Past Accepting new patients
Bethany Medical Center Family Medicine Past Accepting new patients

Locations

3604 Peters Ct
High Point, NC 27265
Phone (336) 812-3610

3605 Peters Ct
High Point, NC 27265
Phone (336) 841-1850

3610 Peters Ct
High Point, NC 27265

507 N Lindsay St
High Point, NC 27262

645 N Main St
High Point, NC 27260
Phone (336) 882-7700

495 Arbor Hill Rd
Ste M
Kernersville, NC 27284

5093 University Pkwy
Winston Salem, NC 27106

Interoperability endpoints

  • Direct secure messaging: codymyrick@bethanymed.allscriptsdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1043851801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MAIN ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272605017",
            "telephone_number": "336-883-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5093 UNIVERSITY PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271066085",
            "telephone_number": "336-883-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRICK",
        "first_name": "CODY",
        "middle_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-03",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "0010-09573",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.