NPIMap

Organization Active NPI

Coddington Physical Therapy, LLC

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1740503739
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CODDINGTON PHYSICAL THERAPY, LLC
Practice address
1550 S Coddington Ave
Suite C
Lincoln, NE 68522-4402
Phone
(402) 423-0303
Fax
(402) 423-0202
NPI assigned
Mar 5, 2010
Last updated
Dec 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Dr. Casey Jonathan Moeller, D.P.T. B.S.NPI 1205881471
Title
Owner/Physical Therapist
Phone
(402) 826-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1550 S Coddington Ave
Suite C
Lincoln, NE 68522-4402

Mailing address

1550 S Coddington Ave Ste C
Lincoln, NE 68522-4402
Phone (402) 423-0303

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100805001050 NE Part B Supplier - Clinic/Group Practice 4486787793 Receives reassigned benefits from 5 practitioners
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Locations

18780 S 68th St
Hickman, NE 68372

18780 S 68th St
Ste A
Hickman, NE 68372
Phone (402) 792-2223

1550 S Coddington Ave
Lincoln, NE 68522
Phone (402) 435-8241

1550 S Coddington Ave
Ste C
Lincoln, NE 68522
Phone (402) 423-0303

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1740503739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 S CODDINGTON AVE STE C",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685224402",
            "telephone_number": "402-423-0303",
            "fax_number": "402-423-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S CODDINGTON AVE",
            "address_2": "SUITE C",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685224402",
            "telephone_number": "402-423-0303",
            "fax_number": "402-423-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODDINGTON PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-05",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "MOELLER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "402-826-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.T. B.S."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.