Active NPI
Cody Green
- Physical Therapy Assistant
- Charleston, WV
National Provider Identifier
1831915214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 002581
- Practice address
- 24 Bridlewood Rd
Charleston, WV 25314-2101 - Phone
- (304) 550-6935
- NPI assigned
- Dec 2, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 002581 | WV | Primary |
Addresses
Primary practice location
24 Bridlewood Rd
Charleston, WV 25314-2101
Mailing address
400 Tracy Way Ste 100
Charleston, WV 25311-1280
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002581 | WV | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care at Home of West Virginia, LLC | Past | Accepting new patients | |
| Mountaineer Homecare, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Home Health Agency
- Charleston, WV
- NPI 1710143375
-
- Nurse Practitioner
- Charleston, WV
- NPI 1386163392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1831915214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 TRACY WAY STE 100",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253111280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 BRIDLEWOOD RD",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253142101",
"telephone_number": "304-550-6935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "CODY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-02",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WV",
"license": "002581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.