Cody Leatherwood

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8665 Issued in GA

Practice address

302 Catamaran Rd
Swansboro, NC 28584-2505

Phone

(770) 853-6522

NPI assigned

Oct 29, 2018

Last updated

Oct 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Merit-based Incentive Payment System (MIPS)

Final score

92.02 of 100Reported as group

Quality

91.38

Improvement activities

40

Cost

79.01

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Georgia Emergency Department Services, P.C.

  • Emergency Medicine Physician
  • Gainesville, GA
  • NPI 1508886912
  Medicare reassignment

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1235606138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 774",
            "city": "BUCHANAN",
            "state": "GA",
            "postal_code": "301130774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CATAMARAN RD",
            "city": "SWANSBORO",
            "state": "NC",
            "postal_code": "285842505",
            "telephone_number": "770-853-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERWOOD",
        "first_name": "CODY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jiaming Geng DDS PA
• Sharna Michelle Jones, LICENSED OPTICIAN
• Cassie Joyner
• Jill H Kidd
• Kenna Marie Kleinert
• Life Tide Counseling PC
• Katherine Light, MSW, LCSWA
• Lomakatsi, PLLC
• Emily Long
• Matthew Thomas Long, PA-C

• Physician Assistant in Swansboro, NC
• Providers in Swansboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.