Individual provider Active NPI

Cody Allen Digiovanni, PT

  • Physical Therapist
  • Roscoe, IL
National Provider Identifier
1396411591
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070024156 Issued in IL
Practice address
5605 E Rockton Rd
Roscoe, IL 61073-7601
Phone
(815) 525-4410
Fax
(815) 525-4505
NPI assigned
Aug 18, 2021
Last updated
Aug 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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 14481 WI
Physical Therapist 225100000X 070024156 IL Primary

Addresses

Primary practice location

5605 E Rockton Rd
Roscoe, IL 61073-7601

Mailing address

1969 W Hart Rd
Beloit, WI 53511-2298
Phone (608) 364-5173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211028000211 IL Practitioner - Physical Therapist in Private Practice 4789072588 Reassigns benefits to 1 organization
I20211028001236 WI Practitioner - Physical Therapist in Private Practice 4789072588 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070024156ILMDPhysical Therapist
14481WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Clinic, S.C. Current Accepting new patients
Beloit Health System, Inc CurrentSince Aug 20, 2021 Accepting new patients
Beloit Health System Inc Current Accepting new patients
Beloit Health System Inc CurrentSince Aug 20, 2021 Accepting new patients
Beloit Health System, Inc CurrentSince Aug 20, 2021 Accepting new patients

Locations

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1650 Lee Ln
Beloit, WI 53511
Phone (608) 364-4666

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

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": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1396411591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1969 W HART RD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112298",
            "telephone_number": "608-364-5173",
            "fax_number": "608-363-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 E ROCKTON RD",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610737601",
            "telephone_number": "815-525-4410",
            "fax_number": "815-525-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIOVANNI",
        "first_name": "CODY",
        "middle_name": "ALLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14481",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roscoe, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.