Active NPI
Cody Lashay Anderson, RN
- Emergency Registered Nurse
- Fort Worth, TX
National Provider Identifier
1982292231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Registered Nurse
- License
- 912117
- Practice address
- 4333 Western Center Blvd
Fort Worth, TX 76137-2036 - Phone
- (817) 232-1634
- NPI assigned
- Jan 4, 2021
- Last updated
- Jan 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | 912117 | TX | Primary |
| Pediatric Registered Nurse | 163WP0200X | 912117 | TX |
Addresses
Primary practice location
4333 Western Center Blvd
Fort Worth, TX 76137-2036
Mailing address
2004 Edmonia CT
Fort Worth, TX 76105-2821
Phone (817) 209-9103
Other names 1
- Prof. Cody Lashay Anderson
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
| License | State | Type | Specialty |
|---|---|---|---|
| 912117 | TX | MD | Emergency Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609718400000",
"number": "1982292231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2004 EDMONIA CT",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761052821",
"telephone_number": "817-209-9103",
"fax_number": "281-606-0354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4333 WESTERN CENTER BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761372036",
"telephone_number": "817-232-1634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "CODY",
"middle_name": "LASHAY",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-04",
"last_updated": "2021-01-04",
"certification_date": "2020-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "TX",
"license": "912117",
"primary": true
},
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "TX",
"license": "912117",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CODY",
"last_name": "ANDERSON",
"middle_name": "LASHAY",
"prefix": "PROF.",
"credential": "RN, BSN",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.