Active NPI
Cody Shafer, M.D.
- Orthopaedic Surgery Physician
- Kokomo, IN
National Provider Identifier
1730561291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 01083629A
- Practice address
- 1907 W Sycamore St # 200
Kokomo, IN 46901-5148 - Phone
- (765) 236-8170
- NPI assigned
- Jun 22, 2015
- Last updated
- Aug 16, 2022
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 01083629A | IN | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | 11018165A | IN |
Addresses
Primary practice location
1907 W Sycamore St # 200
Kokomo, IN 46901-5148
Mailing address
1907 W Sycamore St # 200
Kokomo, IN 46901-5148
Other practice location 1
1120 W Michigan St Rm 600
Indianapolis, IN 46202-5209
Phone (317) 274-3291
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cody.shafer.1@7598.direct.athenahealth.com | St. Vincent Medical Group, Inc. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Indiana University School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1907 W Sycamore St
Suite 200
Kokomo, IN 46901-5148
Phone (765) 236-8170
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 1-10 |
| Knee replacement | 17 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11018165A | IN | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincent Medical Group Inc | Past | Accepting new patients |
Interoperability endpoints
- cody.shafer.1@7598.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ascension Medical Group St. Vincent
- Orthopaedic Surgery Physician
- Winchester, IN
- NPI 1144513375
-
- Cardiovascular Disease Physician
- Indianapolis, IN
- NPI 1558686436
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Logansport, IN
- NPI 1356320469
-
dba Ascension St. Vincent Kokomo
- General Acute Care Hospital
- Kokomo, IN
- NPI 1780625442
-
dba Ascension at Home
- Home Health Agency
- Pendleton, IN
- NPI 1942376843
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660608000000",
"number": "1730561291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 W SYCAMORE ST # 200",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469015148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 W SYCAMORE ST # 200",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469015148",
"telephone_number": "765-236-8170"
}
],
"practiceLocations": [
{
"address_1": "1120 W Michigan St Rm 600",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462025209",
"country_code": "US",
"telephone_number": "317-274-3291",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAFER",
"first_name": "CODY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-22",
"last_updated": "2022-08-16",
"certification_date": "2022-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IN",
"license": "01083629A",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IN",
"license": "11018165A",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cody.shafer.1@7598.direct.athenahealth.com",
"affiliation": "Y",
"affiliationName": "St. Vincent Medical Group, Inc.",
"address_1": "1907 W Sycamore St # 200",
"city": "Kokomo",
"state": "IN",
"country_code": "US",
"postal_code": "469015148",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.