Individual provider Active NPI

Cody Keck, DPT

  • Physical Therapist
  • Cookeville, TN
National Provider Identifier
1992196059
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10301 Issued in TN
Practice address
317 W Spring St
Cookeville, TN 38501-7102
Phone
(931) 526-9518
Fax
(931) 372-0087
NPI assigned
Feb 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10301 TN Primary

Addresses

Primary practice location

317 W Spring St
Cookeville, TN 38501-7102

Mailing address

800 Crescent Centre Dr Ste 300
Franklin, TN 37067-7285
Phone (615) 373-1350

Other practice location 1

851 S Willow Ave Ste 110
Cookeville, TN 38501-4223
Phone (931) 528-0042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150416002408 TN Practitioner - Physical Therapist in Private Practice 1355669649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

335 W Spring St
Cookeville, TN 38501-3125
Phone (931) 526-9518

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10301TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic PC CurrentSince Aug 1, 2022 Accepting new patients
Campbell Clinic, PC CurrentSince Aug 1, 2022 Accepting new patients

Locations

317 W Spring St
Cookeville, TN 38501
Phone (931) 520-9250

335 W Spring St
Cookeville, TN 38501
Phone (931) 303-0446

105 S Willow Ave
Ste 100
Cookeville, TN 38501
Phone (931) 267-4929

105 S Willow Ave
Cookeville, TN 38501
Phone (931) 372-7716

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

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.

NPI Registry JSON

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1992196059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677285",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W SPRING ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385017102",
            "telephone_number": "931-526-9518",
            "fax_number": "931-372-0087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 S Willow Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385014223",
            "country_code": "US",
            "telephone_number": "931-528-0042",
            "fax_number": "931-528-0049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KECK",
        "first_name": "CODY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-11",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.