Individual provider Active NPI

Cody Stayden

  • Geriatric Medicine (Internal Medicine) Physician
  • Cincinnati, OH
National Provider Identifier
1144943457
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
RN.426916 Issued in OH
Practice address
6114 Woodmont Ave
Cincinnati, OH 45213-1714
Phone
(513) 600-6585
NPI assigned
Sep 21, 2022
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X RN.426916 OH Primary

Addresses

Primary practice location

6114 Woodmont Ave
Cincinnati, OH 45213-1714

Mailing address

6114 Woodmont Ave
Cincinnati, OH 45213-1714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20221021001245 OH Practitioner - Nurse Practitioner 1557737178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dedicated Ohio Holding LLCGroup PAC ID 2769718659, 7 clinicians

Practice addresses (Care Compare)

5050 Glencrossing Way
Cincinnati, OH 45238-3360
Phone (513) 813-4311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.426916OHMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Ohio Holding, LLC CurrentSince Jul 1, 2023 Accepting new patients
Dedicated Ohio Holding LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

5050 Glencrossing Way
Cincinnati, OH 45238
Phone (513) 813-4311

7642 Reading Rd
Cincinnati, OH 45237
Phone (513) 208-2880

Organizations & group practices 2

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": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1144943457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6114 WOODMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452131714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6114 WOODMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452131714",
            "telephone_number": "513-600-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAYDEN",
        "first_name": "CODY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OH",
            "license": "RN.426916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.