Individual provider Active NPI

Cody Reid Johnson

  • Student in an Organized Health Care Education/Training Program
  • Danville, PA
National Provider Identifier
1104241595
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
100 N Academy Ave
Danville, PA 17822-9800
Phone
(570) 271-6301
Fax
(570) 271-5976
NPI assigned
Feb 22, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Diagnostic Radiology Physician 2085R0202X MD486964 PA

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-9800

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, OH, SC, PA, IN, IL7 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
I20200617002156 DC Practitioner - Diagnostic Radiology 1254753411 Reassigns benefits to 1 organization
I20210813000279 VA Practitioner - Diagnostic Radiology 1254753411 Reassigns benefits to 2 organizations
I20230607000502 OH Practitioner - Diagnostic Radiology 1254753411 Reassigns benefits to 1 organization
I20241014004405 SC Practitioner - Diagnostic Radiology 1254753411 Reassigns benefits to 4 organizations
I20241120001589 PA Practitioner - Diagnostic Radiology 1254753411 Reassigns benefits to 1 organization
I20241227001608 IN Practitioner - Diagnostic Radiology 1254753411 Reassigns benefits to 1 organization
I20260108000152 IL Practitioner - Diagnostic Radiology 1254753411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Toledo College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101258741VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Clarendon Multi-Specialty CurrentSince Sep 25, 2024 Accepting new patients
Riverside Physician Services, Inc. Multi-Specialty CurrentSince Feb 1, 2024 Accepting new patients
McLeod Loris Seacoast Hospital Multi-Specialty CurrentSince Sep 25, 2024 Accepting new patients
Lutheran Medical Group LLC CurrentSince Nov 23, 2024 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 25, 2024 Accepting new patients
Riverside Physician Services Inc Multi-Specialty Current Accepting new patients
McLeod Medical Center-Dillon Multi-Specialty CurrentSince Sep 25, 2024 Accepting new patients
Lutheran Medical Group LLC Multi-Specialty CurrentSince Nov 23, 2024 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Multi-Specialty CurrentSince Dec 1, 2025 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Sep 25, 2024 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Multi-Specialty CurrentSince Dec 1, 2025 Accepting new patients
McLeod Health Clarendon Multi-Specialty Current Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Multi-Specialty CurrentSince Sep 25, 2024 Accepting new patients
Cardiology Consultants of Philadelphia, P.C. Multi-Specialty CurrentSince Dec 2, 2024 Accepting new patients
McLeod Health Clarendon Multi-Specialty CurrentSince Sep 25, 2024 Accepting new patients
University Hospitals Medical Group Inc Multi-Specialty CurrentSince Jul 1, 2023 Accepting new patients
Riverside Physician Services Inc Multi-Specialty CurrentSince Feb 1, 2024 Accepting new patients
McLeod Medical Center-Dillon CurrentSince Sep 25, 2024 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Multi-Specialty Past Accepting new patients

Locations

721 E Court St
Paris, IL 61944
Phone (217) 465-4141

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

207 N Broad St
Fl 3
Philadelphia, PA 19107
Phone (215) 361-5020

1703 S Broad St
Ste 300
Philadelphia, PA 19148
Phone (215) 462-7100

301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

12200 Warwick Blvd
Ste 590B
Newport News, VA 23601
Phone (757) 534-5909

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

Interoperability endpoints

  • Direct secure messaging: cjohnson214544@ehrdirect.uhhospitals.org

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 8

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": "1393027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1104241595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6301",
            "fax_number": "570-271-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6301",
            "fax_number": "570-271-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CODY",
        "middle_name": "REID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-22",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD486964",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.