Individual provider Active NPI

Cody Benjamin Somerville, DC

  • Chiropractor
  • York, PA
National Provider Identifier
1497464457
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011787 Issued in PA
Practice address
1776 S Queen St # 101B
York, PA 17403-4628
Phone
(717) 848-5400
NPI assigned
Nov 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC011787 PA Primary

Addresses

Primary practice location

1776 S Queen St # 101B
York, PA 17403-4628

Mailing address

1776 S Queen St # 101B
York, PA 17403-4628
Phone (717) 848-5400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221209000901 PA Practitioner - Chiropractic 5193194355 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC011787PAMDChiropractor

Organizations & group practices 1

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": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1497464457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 S QUEEN ST # 101B",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034628",
            "telephone_number": "717-848-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 S QUEEN ST # 101B",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034628",
            "telephone_number": "717-848-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "CODY",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-18",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.