Individual provider Active NPI

Cody W Choate, PTA

  • Physical Therapy Assistant
  • Jacksonville Beach, FL
National Provider Identifier
1073867669
Registry record updated Nov 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2369 Issued in AR
Practice address
333 1St St N Ste 200
Jacksonville Beach, FL 32250-6939
Phone
(904) 241-8332
NPI assigned
Nov 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2369 AR Primary
Physical Therapy Assistant 225200000X 2087239 TX

Addresses

Primary practice location

333 1St St N Ste 200
Jacksonville Beach, FL 32250-6939

Mailing address

702 S Columbus St
Spiro, OK 74959-2634

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

State licenses

LicenseStateTypeSpecialty
2369ARMDPhysical Therapist
2087239TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1351900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351900800000",
    "number": "1073867669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 S COLUMBUS ST",
            "city": "SPIRO",
            "state": "OK",
            "postal_code": "749592634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 1ST ST N STE 200",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506939",
            "telephone_number": "904-241-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOATE",
        "first_name": "CODY",
        "middle_name": "W",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-03",
        "last_updated": "2012-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "2369",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2087239",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.