Individual provider Active NPI

Cody F Davis, DPT

  • Physical Therapist
  • Issaquah, WA
National Provider Identifier
1508424920
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60966226 Issued in WA
Practice address
510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449
Phone
(425) 313-3051
Fax
(425) 313-3055
NPI assigned
May 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60966226 WA Primary

Addresses

Primary practice location

510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449

Mailing address

510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 313-3051

Other practice location 1

17650 140th Ave SE Ste B7
Renton, WA 98058-6814
Phone (425) 430-0700

Other identifiers 1

IdentifierTypeStateIssuer
2134581MedicaidWA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. Physical Therapist CurrentSince Sep 15, 2020 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Sep 15, 2020 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince May 20, 2019 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince May 20, 2019 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1200 112th Ave NE
Ste C260
Bellevue, WA 98004
Phone (425) 313-3055

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

510 8th Ave NE
Ste 340
Issaquah, WA 98029
Phone (425) 313-3051

510 8th Ave NE
Ste 320
Issaquah, WA 98029

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

17650 140th Ave SE
Ste B7
Renton, WA 98058
Phone (425) 430-0700

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

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 and National Provider Directory roles.

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": "1600300800000",
    "number": "1508424920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-313-3051",
            "fax_number": "425-313-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 340",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295449",
            "telephone_number": "425-313-3051",
            "fax_number": "425-313-3055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17650 140th Ave SE Ste B7",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980586814",
            "country_code": "US",
            "telephone_number": "425-430-0700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CODY",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-31",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60966226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2134581",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.