Individual provider Active NPI

Kody Dewayne McGhee, OT

  • Occupational Therapist
  • Niceville, FL
National Provider Identifier
1083368815
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT22775 Issued in FL
Practice address
1950 Bluewater Blvd Ste 101
Niceville, FL 32578-3888
Phone
(850) 897-3334
Fax
(850) 897-7855
NPI assigned
Feb 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT22775 FL Primary

Addresses

Primary practice location

1950 Bluewater Blvd Ste 101
Niceville, FL 32578-3888

Mailing address

1950 Bluewater Blvd Ste 101
Niceville, FL 32578-3888
Phone (850) 897-3334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220218000778 FL Practitioner - Occupational Therapist in Private Practice 9032503958 Reassigns benefits to 2 organizations
I20250306001689 TX Practitioner - Occupational Therapist in Private Practice 9032503958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poarch Band of Creek IndiansGroup PAC ID 9830188085, 12 clinicians

Practice addresses (Care Compare)

429 Buford L Rolin Dr
Atmore, AL 36502-5190
Phone 25136891362412

Merit-based Incentive Payment System (MIPS)

Final score
52.44 of 100Reported as group
Quality
0
Improvement activities
40
Cost
74.78

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Oct 1, 2024 Accepting new patients
Poarch Band of Creek Indians CurrentSince Feb 1, 2025 Accepting new patients
Orthopedic & Sports Physical Therapy Center LLC CurrentSince Feb 14, 2022 Accepting new patients
North Florida Surgeons, PA CurrentSince Oct 1, 2024 Accepting new patients
Orthopedic & Sports Physical Therapy Center LLC CurrentSince Feb 14, 2022 Accepting new patients

Locations

5811 Jack Springs Rd
Atmore, AL 36502
Phone (251) 368-9136

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

1950 Bluewater Blvd
Ste 101
Niceville, FL 32578
Phone (850) 897-3334

1950 Bluewater Blvd
Ste 100
Niceville, FL 32578
Phone (850) 897-8081

1040 Gulf Breeze Pkwy
Ste 200
Pensacola Beach, FL 32561
Phone (850) 916-8711

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/148f5931-d9cf-4d65-8c66-7021ed161b73/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1083368815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 BLUEWATER BLVD STE 101",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783888",
            "telephone_number": "850-897-3334",
            "fax_number": "850-897-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 BLUEWATER BLVD STE 101",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783888",
            "telephone_number": "850-897-3334",
            "fax_number": "850-897-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGHEE",
        "first_name": "KODY",
        "middle_name": "DEWAYNE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT22775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.