Individual provider Active NPI

Cody Clinton, D.O.

  • Orthopaedic Surgery Physician
  • Glassboro, NJ
National Provider Identifier
1235425190
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
25MB09745400 Issued in NJ
Practice address
221 Victoria St
Glassboro, NJ 08028-2278
Phone
(856) 536-1476
NPI assigned
Jun 20, 2011
Last updated
Mar 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 25MB09745400 NJ Primary

Addresses

Primary practice location

221 Victoria St
Glassboro, NJ 08028-2278

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

1260 E Woodland Ave
Suite 200
Springfield, PA 19064-3969
Phone (610) 690-4480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20150908000304 NJ Practitioner - Sports Medicine 6305061284 Reassigns benefits to 1 organization
I20151026001859 PA Practitioner - Sports MedicinePractitioner - Family Practice 6305061284

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Philadelphia College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Surgical Associates, PAGroup PAC ID 3274430764, 303 clinicians

Practice addresses (Care Compare)

3 Cooper PLZ
RM 104
Camden, NJ 08103-1407
Phone (856) 968-7965

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.23 of 100Reported as group
Quality
77.64
Promoting interoperability
98
Improvement activities
40
Cost
68.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB09745400NJMDOrthopaedic Surgery Physician

Interoperability endpoints

  • Direct secure messaging: cclinton40856@direct.cooperhealth.edu

Organizations & group practices 1

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 2

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1235425190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 VICTORIA ST",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282278",
            "telephone_number": "856-536-1476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1260 E Woodland Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "PA",
            "postal_code": "190643969",
            "country_code": "US",
            "telephone_number": "610-690-4480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "CODY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MB09745400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glassboro, NJ

Sources for this page

Verify at the official NPI Registry.