Active NPI
Cody E Thompson, PA-C
- Surgical Physician Assistant
- St Petersburg, FL
National Provider Identifier
1619953114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA9103535
- Practice address
- 625 6TH Ave S Ste 450
St Petersburg, FL 33701-4629 - Phone
- (727) 898-2663
- Fax
- (727) 568-6836
- NPI assigned
- Dec 16, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9103535 | FL | |
| Surgical Physician Assistant | 363AS0400X | PA9103535 | FL | Primary |
Addresses
Primary practice location
625 6TH Ave S Ste 450
St Petersburg, FL 33701-4629
Mailing address
625 6TH Ave S Ste 450
St Petersburg, FL 33701-4629
Phone (727) 898-2663
Other practice location 1
3440 W Dr Martin Luther King Jr Blvd Ste 200
Tampa, FL 33607-6223
Phone (813) 879-2663
Other practice location 2
8318 Market St
Lakewood Ranch, FL 34202-5137
Phone (727) 898-2663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 292378500 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9103535 | FL | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health, Inc. | Current | Accepting new patients |
Interoperability endpoints
- cthompson734790@direct.hopkinsmedicine.org
- cthompson189367@orlandohealth.medalliesdirect.net
Organizations & group practices 2
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.
-
- Pediatric Orthopaedic Surgery Physician
- St Petersburg, FL
- NPI 1184609851
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747872000000",
"number": "1619953114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 6TH AVE S STE 450",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014629",
"telephone_number": "727-898-2663",
"fax_number": "727-568-6836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 6TH AVE S STE 450",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014629",
"telephone_number": "727-898-2663",
"fax_number": "727-568-6836"
}
],
"practiceLocations": [
{
"address_1": "3440 W Dr Martin Luther King Jr Blvd Ste 200",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336076223",
"country_code": "US",
"telephone_number": "813-879-2663",
"fax_number": "813-872-0286",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8318 Market St",
"address_purpose": "LOCATION",
"city": "Lakewood Ranch",
"state": "FL",
"postal_code": "342025137",
"country_code": "US",
"telephone_number": "727-898-2663",
"fax_number": "727-568-6836",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMPSON",
"first_name": "CODY",
"middle_name": "E",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-16",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9103535",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA9103535",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "292378500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.