Codi Nicole Castleberry, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2891 Issued in OK

Practice address

11426 N 134TH East Ave
Owasso, OK 74055-4715

Phone

(918) 376-6345

Fax

(918) 376-6635

NPI assigned

Feb 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medwise LLCGroup PAC ID 8820410970, 33 clinicians

Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.89 of 100Reported as group

Quality

73.2

Promoting interoperability

100

Improvement activities

40

Cost

79.78

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: codi.castleberry.1@21352.direct.athenahealth.com

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.

• Medwise LLC

  • Urgent Care Clinic/Center
  • Coweta, OK
  • NPI 1629604434
  Medicare reassignment Care Compare group
• AMC Urgent Care Plus, LLC

  • General Practice Physician
  • Ponca City, OK
  • NPI 1285644153
  Medicare reassignment
• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Care Compare group
• Medwise LLC

  • Durable Medical Equipment & Medical Supplies
  • Tulsa, OK
  • NPI 1407656572
  NPD
• Triad Complete Healthcare A06 LLC

  • Primary Care Clinic/Center
  • Stillwater, OK
  • NPI 1932809738
  NPD (past)
• On Demand Urgent Care LLC

  • Urgent Care Clinic/Center
  • Austintown, OH
  • NPI 1811587538
  NPD (past)

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1922508266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11426 N 134TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554715",
            "telephone_number": "918-376-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11426 N 134TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554715",
            "telephone_number": "918-376-6345",
            "fax_number": "918-376-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTLEBERRY",
        "first_name": "CODI",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tucker B Carter
• Jacob M Cary, D.D.S.
• Ashlie Casey, LCSW
• David L Cash, O.D.
• Riley Castle
• Kyle Cavitt, DC
• CCC of Owasso Inc
• Centurion Health Systems, Inc
• Vang Youa Chang
• Allena Chapman, RD, LD

• Physician Assistant in Owasso, OK
• Providers in Owasso, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.