MR. CODY LEVI NELSON (NPI# 1790334118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790334118 |
| Entity Type | Individual |
| Full Name | MR. CODY LEVI NELSON |
| Credential | MSN, RN, PMHNP-BC |
| Practice Address |
1116 N 16th St Lafayette IN 47904-2119 |
| Mailing Address |
Po Box 781076 Detroit MI 48278-1076 |
| Practice Telephone | 7654236300 |
| Mailing Telephone | 3175284800 |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2020-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 28229694A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
71010196A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | STATE OF INDIANA NURSING BOARD - CSR PRESCRIPTIVE AUTHORITY | 71010195B | 01 |
| IN | STATE OF INDIANA NURSING BOARD | 28229694A | 01 |
| IN | STATE OF INDIANA NURSING BOARD - APRN PRESCRIPTIVE AUTHORITY | 71010195A | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1701 S Creasy Ln, Lafayette, IN 479054972 | 7655024001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053947051 | Cody Shaw Nelson | Student in an Organized Health Care Education/Training Program | 75 Francis St, Boston, MA 02115-6106 | 2020-03-21 |
| 1891329116 | Cody Richard Nelson | Pharmacist | 1915 Wisconsin Ave, Grafton, WI 53024-2605 | 2020-02-25 |
| 1801209184 | Cody Nelson | Physical Therapist | 8540 Scarborough Dr Ste 200, Colorado Springs, CO 80920-7513 | 2014-06-04 |
| 1376773788 | Cody James Nelson | Dentist | 620 John Paul Jones Circle, Portsmouth, VA 23708 | 2009-07-20 |
| Street Address |
1116 N 16TH ST |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47904-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952370991 | Corby Louise Thiel | Nurse Practitioner | 1116 N 16th St, Lafayette, IN 47904-2119 | 2006-03-14 |
| 1225500747 | Genoia Beth Segal | Registered Nurse | 1116 N 16th St, Lafayette, IN 47904-2119 | 2018-12-21 |
| 1417444944 | Ashley Turner | Nurse Practitioner | 1116 N 16th St, Lafayette, IN 47904 | 2018-04-19 |
| 1821596040 | Elizabeth Ann Lana | Registered Nurse | 1116 N 16th St, Lafayette, IN 47904-2119 | 2018-01-23 |
| 1255846697 | Kelli Ann Conlon | Social Worker | 1116 N 16th St, Lafayette, IN 47904-2119 | 2017-12-07 |
| 1750896569 | Mick A Schoenradt | Counselor | 1116 N 16th St, Lafayette, IN 47904-2119 | 2017-12-04 |
| 1255869319 | Amanda Marie Crosby | Dietitian, Registered | 1116 N 16th St, Lafayette, IN 47904-2119 | 2017-06-01 |
| 1962939652 | Anne Caroline Johnson | Physical Therapist | 1116 N 16th St, Lafayette, IN 47904-2119 | 2017-05-12 |
| 1154705002 | Mary C Eberle | Social Worker | 1116 N 16th St, Lafayette, IN 47904-2119 | 2015-07-09 |
| 1871986661 | Autumn Wall | Social Worker | 1116 N 16th St, Lafayette, IN 47904-2119 | 2015-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568998615 | Angela Hands | Physical Therapy Assistant | 1260 North 17th Street, Lafayette, IN 47904 | 2017-05-11 |
| 1366894164 | Kathryn Barnett | Behavioral Analyst | 2785 Cason St # 2, Lafayette, IN 47904 | 2016-07-06 |
| 1881972917 | Rest Assured, LLC | Durable Medical Equipment & Medical Supplies | 180 Professional Ct., Lafayette, IN 47904 | 2011-07-22 |
| 1144514233 | Michelle Cristin Singleton | Dietitian, Registered | 508 N 26th St, Lafayette, IN 47904 | 2011-06-06 |
| 1912134438 | Jean D Trammel | Marriage & Family Therapist | 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 | 2009-06-11 |
| 1902946056 | Terry Richard Baker | Optometrist | 2300 Sagamore Parkway S, Lafayette, IN 47904 | 2007-02-07 |
| 1891862165 | Becki A Bowditch Inc | Social Worker | 2201 Ferry Street, Lafayette, IN 47904 | 2006-11-29 |
| 1326121849 | James Lowell Thomas | Pediatrics | 2300 Ferry St, Lafayette, IN 47904 | 2006-10-21 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1255428801 | Lynn Arlen Pestle | Dentist | 2550 Elmwood Avenue, Lafayette, IN 47904 | 2006-10-06 |
| Find all providers in zip 47904 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376169979 | Nancy Ariwodo | Nurse Practitioner | 225 Rue La France, Lafayette, LA 70508-1565 | 2020-06-19 |
| 1114558715 | Danielle J Threatts Aprn LLC | Nurse Practitioner | 208 W Gloria Switch Rd Ste 219, Lafayette, LA 70507-3409 | 2020-02-01 |
| 1992359848 | Harold G Frizzell Psychiatric Services LLC | Nurse Practitioner | 300 Thompson Loop, Lafayette, LA 70506-2820 | 2019-07-29 |
| 1154801876 | Seth Jordan Bowers | Nurse Practitioner | 4906 Ambassador Caffery Pkwy # B, Lafayette, LA 70508-6962 | 2018-08-21 |
| 1205351137 | Laura Lee Kight | Nurse Practitioner | 215 Rue Fontaine, Lafayette, LA 70508-5742 | 2017-08-11 |
| 1295273837 | Cinderella Broussard LLC | Nurse Practitioner | 208 W Gloria Switch Rd # 6, Lafayette, LA 70507-3409 | 2017-02-02 |
| 1811441702 | Amanda Barfield, LLC | Nurse Practitioner | 103 Epinal Dr, Lafayette, LA 70507-3241 | 2016-08-08 |
| 1437500519 | April Breaux | Nurse Practitioner | 114 Representative Row Ste B, Lafayette, LA 70508-3878 | 2016-06-29 |
| 1497119481 | Acadiana Healthcare Solutions LLC | Nurse Practitioner | 711 N Pierce St, Lafayette, LA 70501-3529 | 2016-04-06 |
| 1477926715 | Lisa A. Chavis LLC | Nurse Practitioner | 2826 Louisiana Ave, 1202, Lafayette, LA 70501-1383 | 2015-11-09 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.