Individual provider Active NPI

Cody Sadikoff, RN

  • General Practice Registered Nurse
  • Lake Geneva, WI
National Provider Identifier
1891635165
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
1111571-30 Issued in WI
Practice address
709 Marshall St Uppr
Lake Geneva, WI 53147-1435
Phone
(262) 325-4454
NPI assigned
Mar 30, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 1111571-30 WI Primary

Addresses

Primary practice location

709 Marshall St Uppr
Lake Geneva, WI 53147-1435

Mailing address

709 Marshall St Uppr
Lake Geneva, WI 53147-1435
Phone (262) 325-4454

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1111571-30WIMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1891635165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 MARSHALL ST UPPR",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471435",
            "telephone_number": "262-325-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 MARSHALL ST UPPR",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471435",
            "telephone_number": "262-325-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADIKOFF",
        "first_name": "CODY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "WI",
            "license": "1111571-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.