Individual provider Active NPI

Cody Castle, FNP

  • Family Nurse Practitioner
  • Longview, TX
National Provider Identifier
1417481623
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP134335 Issued in TX
Practice address
1103 Eden Dr
Longview, TX 75605-3114
Phone
(903) 578-0887
NPI assigned
Apr 13, 2017
Last updated
Feb 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP134335 TX Primary

Addresses

Primary practice location

1103 Eden Dr
Longview, TX 75605-3114

Mailing address

816 W Cannon St
Fort Worth, TX 76104-3146
Phone (817) 321-0404

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20171005000472 TX Practitioner - Nurse Practitioner 4183999832 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1121 E Hawkins Pkwy
Longview, TX 75605-8068
Phone (817) 321-0404

5425 W Spring Creek Pkwy
110 Village Imaging Center
Plano, TX 75024-4236
Phone (817) 321-0937

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of North Texas, PA CurrentSince Feb 1, 2020 Accepting new patients
Acs Primary Care Physicians Southwest, PA Family CurrentSince Jul 1, 2017 Accepting new patients
Clinical Care in Radiology CurrentSince Feb 28, 2024 Accepting new patients
Radiology Associates of North Texas PA CurrentSince Feb 1, 2020 Accepting new patients

Locations

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

1622 8th Ave
Ste 120
Fort Worth, TX 76104
Phone (817) 923-8220

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

1814 Roseland Blvd
Ste 100
Tyler, TX 75701
Phone (214) 696-8033

Organizations & group practices 4

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": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1417481623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043146",
            "telephone_number": "817-321-0404",
            "fax_number": "817-321-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 EDEN DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756053114",
            "telephone_number": "903-578-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTLE",
        "first_name": "CODY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.