Individual provider Active NPI

Codi Caine, CPNP

  • Pediatric Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1801126495
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN0000014485 Issued in TN
Practice address
881 Professional Park Drive
Clarksville, TN 37040
Phone
(931) 645-4685
Fax
(931) 245-2117
NPI assigned
Jan 5, 2010
Last updated
Oct 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209.007946 IL
Pediatric Nurse Practitioner 363LP0200X APN0000014485 TN Primary

Addresses

Primary practice location

881 Professional Park Drive
Clarksville, TN 37040

Mailing address

881 Professional Park Drive
Clarksville, TN 37040
Phone (931) 645-4685

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.007946ILMDPediatric Nurse Practitioner
APN0000014485TNMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1801126495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 PROFESSIONAL PARK DRIVE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "931-645-4685",
            "fax_number": "931-245-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 PROFESSIONAL PARK DRIVE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "931-645-4685",
            "fax_number": "931-245-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAINE",
        "first_name": "CODI",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209.007946",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN0000014485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.