Active NPI
Heather Cody
- Geriatric Physical Therapist
- Bridgeport, CT
National Provider Identifier
1629445135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 10588
- Practice address
- 4200 Park Ave
Bridgeport, CT 06604-1049 - Phone
- (203) 396-1136
- NPI assigned
- Sep 1, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 10588 | CT | Primary |
Addresses
Primary practice location
4200 Park Ave
Bridgeport, CT 06604-1049
Mailing address
175 Jefferson St
Fairfield, CT 06825-1078
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611100800000",
"number": "1629445135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 JEFFERSON ST",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068251078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 PARK AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066041049",
"telephone_number": "203-396-1136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CODY",
"first_name": "HEATHER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-01",
"last_updated": "2021-01-20",
"certification_date": "2021-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "CT",
"license": "10588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.