MR. CODY LEE WALLS (NPI# 1821341447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821341447 |
| Entity Type | Individual |
| Full Name | MR. CODY LEE WALLS |
| Credential | ATC, LAT, EMT |
| Practice Address |
4001 Summerhill Rd Texarkana TX 75503-2764 |
| Practice Telephone | 9037943891 |
| Mailing Telephone | 9037943891 |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2012-10-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 146N00000X | Emergency Medical Technician, Basic | 22756 | AR | Emergency Medical Service Providers |
| N | 146N00000X | Emergency Medical Technician, Basic | 168141 | TX | Emergency Medical Service Providers |
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT4598 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 174H00000X | Health Educator | 1634643 | TX | Other Service Providers |
| Street Address |
4001 SUMMERHILL RD |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-2764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669924726 | Forestt Bridges | Specialist/Technologist | 4001 Summerhill Rd, Texarkana, TX 75503-2764 | 2016-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861951766 | Sarah M Seedle | Specialist/Technologist | 2501 E 42nd St, Texarkana, AR 71854-2036 | 2019-03-19 |
| 1952886905 | Stephanie Michelle Scott | Specialist/Technologist | 5406 Mcknight Rd, Texarkana, TX 75503-0957 | 2018-09-26 |
| 1235648619 | Susan Taah | Specialist/Technologist | 3500 Washington St Apt 1510, Texarkana, AR 71854-5894 | 2017-09-28 |
| 1124513502 | Hannah Fitch | Specialist/Technologist | 4241 Summerhill Rd, Texarkana, TX 75503-2733 | 2018-06-27 |
| 1063937944 | Taylor Ashtyn Scott | Specialist/Technologist | 3512 Grand Ave, Texarkana, AR 71854-2232 | 2017-08-11 |
| 1669924726 | Forestt Bridges | Specialist/Technologist | 4001 Summerhill Rd, Texarkana, TX 75503-2764 | 2016-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932562 | Kyndall Leigh Soukup | Specialist/Technologist | 16002 Rosethorn Ct, Cypress, TX 77429-3490 | 2020-11-03 |
| 1447850631 | Claire Oliver-dehaven | Specialist/Technologist | 7012 Ridgetop Rd, North Richland Hills, TX 76182-3331 | 2020-10-28 |
| 1609476894 | Tessa Mcelroy | Specialist/Technologist | 1606 Trail Glen Ct, Pantego, TX 76013-3152 | 2020-10-28 |
| 1265031702 | Kiana Angelique Leveston | Specialist/Technologist | 2820 W Frey St Apt 7209, Stephenville, TX 76401-1905 | 2020-10-24 |
| 1205435856 | Jessica Moreno | Specialist/Technologist | 3718 Duck Creek Dr, Garland, TX 75043-2962 | 2020-10-23 |
| 1437758612 | Dina Y Scott | Specialist/Technologist | 107 N Greenville Ave Ste B, Allen, TX 75002-9161 | 2020-10-20 |
| 1275131864 | Kasie Bell | Specialist/Technologist | 215 Richland Dr, Kilgore, TX 75662-2049 | 2020-10-15 |
| 1184222663 | Zachary Mitchell Kimo Mitsui | Specialist/Technologist | 7311 Bluestone Rd, San Antonio, TX 78249 | 2020-10-15 |
| 1538766191 | Francisco Ruben Perez | Specialist/Technologist | 2503 6th St, Lubbock, TX 79409-9806 | 2020-10-07 |
| 1356958128 | Brandi Neeley | Specialist/Technologist | 12131 Kirby Dr, Houston, TX 77045-4857 | 2020-09-25 |
| Find all providers with the same taxonomy | ||||
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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.