Individual provider Active NPI

Cody Hullman, PT

  • Physical Therapist
  • Prairie Village, KS
National Provider Identifier
1245682525
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-05324 Issued in KS
Practice address
5200 W 94TH Ter Ste 112
Prairie Village, KS 66207-2534
Phone
(913) 224-2990
Fax
(913) 224-2992
NPI assigned
Jul 11, 2016
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2017021992 MO
Physical Therapist 225100000X 11-05324 KS Primary

Addresses

Primary practice location

5200 W 94TH Ter Ste 112
Prairie Village, KS 66207-2534

Mailing address

5200 W 94TH Ter Ste 112
Prairie Village, KS 66207-2534
Phone (913) 224-2990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170814000960 KS Practitioner - Physical Therapist in Private Practice 4880989128 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-05324KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empower PTP Lenexa Physical Therapist CurrentSince Aug 8, 2021 Accepting new patients
Ascension Via Christi Hospital Manhattan, Inc. CurrentSince Jan 3, 2026 Accepting new patients
Ascension Via Christi Hospital Manhattan, Inc. Current Accepting new patients
Ascension Via Christi Hospital Manhattan, Inc. CurrentSince Jan 3, 2026 Accepting new patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Jun 1, 2020 Accepting new patients

Locations

1823 College Ave
Manhattan, KS 66502
Phone (785) 539-1704

5200 W 94th Ter
Ste 112
Prairie Village, KS 66207
Phone (913) 224-2990

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

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, 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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1245682525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 W 94TH TER STE 112",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662072534",
            "telephone_number": "913-224-2990",
            "fax_number": "913-224-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 W 94TH TER STE 112",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662072534",
            "telephone_number": "913-224-2990",
            "fax_number": "913-224-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULLMAN",
        "first_name": "CODY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2017021992",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-05324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Village, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.