Cody'S Center of Hope, Dedicated Pediatric Care, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CODY'S CENTER OF HOPE, DEDICATED PEDIATRIC CARE, PC

Practice address

2565 Horizon Lake Dr Ste 114
Memphis, TN 38133-8113

Phone

(901) 350-2639

Fax

(901) 249-4563

NPI assigned

May 1, 2018

Organization subpart

No

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

Authorized official

Name

Lori R HoltzmanNPI 1023018587

Title

President

Phone

(901) 350-2639

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17965/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lori Rae Holtzman, MD

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1023018587
  Medicare reassignment NPD Authorized official
• Angela Marie Schulz, M.D.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1639279847
  NPD

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1740778166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381442",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831442",
            "telephone_number": "901-350-2639",
            "fax_number": "901-249-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 HORIZON LAKE DR STE 114",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381338113",
            "telephone_number": "901-350-2639",
            "fax_number": "901-249-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODY'S CENTER OF HOPE, DEDICATED PEDIATRIC CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "HOLTZMAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-350-2639"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4350171",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3496002",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latanya E Cochran, M.ED.
• Madelyn Cochran, RN
• Thialana D Cochran, BS
• Mathilda C Coday, PHD
• Shenita Cody, CRNA
• Jordan Alyse Coffelt, AU.D.
• Laureen McLaren Coffelt, O.T.
• Jennifer Ashley Coffey, C.M.S.W.
• Jordan Thomas Coffey, MD
• Rebecca Anne Coggin, OTR/L

• Pediatrics Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.