Individual provider Active NPI

Cody Aaron Walker, PT, DPT, OTR/L, MOT

  • Occupational Therapist
  • Jacksonville, FL
National Provider Identifier
1316232804
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT15238 Issued in FL
Practice address
145 Heron Bay Rd
Jacksonville, FL 32218-3595
Phone
(904) 470-6900
NPI assigned
Jun 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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 PT26262 FL
Occupational Therapist 225X00000X OT15238 FL Primary

Addresses

Primary practice location

145 Heron Bay Rd
Jacksonville, FL 32218-3595

Mailing address

4650 State Road 16
St Augustine, FL 32092-0600
Phone (904) 940-2193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT15238FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physical Therapy, PLLC Physical Therapist CurrentSince Feb 10, 2023 Accepting new patients
Metro Pavia Healthcare Center PastSince Jun 30, 2024 Accepting new patients

Locations

1305 N Orange Ave
Ste 118
Green Cove Springs, FL 32043
Phone (904) 531-5500

2219 County Road 220
Ste 304
Middleburg, FL 32068
Phone (360) 707-8107

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1316232804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 STATE ROAD 16",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320920600",
            "telephone_number": "904-940-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HERON BAY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183595",
            "telephone_number": "904-470-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CODY",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, OTR/L, MOT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26262",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT15238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.