Active NPI
Cody Henry, PTA
- Physical Therapy Assistant
- Lebanon, PA
National Provider Identifier
1447818802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TE012132
- Practice address
- 945 Duke St
Lebanon, PA 17042-7216 - Phone
- (717) 274-1495
- NPI assigned
- May 31, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TE012132 | PA | Primary |
Addresses
Primary practice location
945 Duke St
Lebanon, PA 17042-7216
Mailing address
528 Mandarin LN
Elizabethtown, PA 17022-7808
Phone (717) 364-9692
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TE012132 | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559260800000",
"number": "1447818802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 MANDARIN LN",
"city": "ELIZABETHTOWN",
"state": "PA",
"postal_code": "170227808",
"telephone_number": "717-364-9692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 DUKE ST",
"city": "LEBANON",
"state": "PA",
"postal_code": "170427216",
"telephone_number": "717-274-1495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "CODY",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-31",
"last_updated": "2019-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TE012132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.