CODY ENRIETTI (PT, DPT) – Physical Therapist, NPI 1063275741

CODY ENRIETTI (PT, DPT) is a healthcare provider. based in Louisville, Kentucky. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. PT004708 (WV). The NPI Number for CODY ENRIETTI (PT, DPT) is 1063275741

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
CODY ENRIETTI (PT, DPT)
NPI
1063275741
Phone
(304) 917-3660
Address
1650 LYNDON FARM CT STE 300
Enumeration Date
5 February 2024
Last Update Date
5 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3047370437
Graduation Year
2023 (3 years ago)
PAC ID
6709227093
Group Practice PAC ID
1759795834
Professional Enrollment ID
I20240517001575
Address ID
WV260701528WE841XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

479 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WV

Provider Addresses for CODY ENRIETTI (PT, DPT)

  • 1650 LYNDON FARM CT STE 300

    LOUISVILLE, KY 402235005

    Phone: (304) 917-3660

    Fax: (812) 590-8333

    Type: Mailing

  • 841 COMMERCE ST

    WELLSBURG, WV 260701528

    Phone: (304) 737-0437

    Fax: (304) 737-0581

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240517001575IPhysical Therapist In Private PracticeWVTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 40223)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759795834View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWV
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeWV
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeWV
Physical Therapist In Private PracticeWV
Physical Therapist In Private PracticeWV
Physical Therapist In Private PracticeWV
Physical Therapist In Private PracticeWV
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

Is CODY ENRIETTI (PT, DPT) listed with a National Provider Identifier?
Yes — CODY ENRIETTI (PT, DPT) has NPI 1063275741 on file in the registry.
Is CODY ENRIETTI (PT, DPT) still an active registrant?
CODY ENRIETTI (PT, DPT) carries an active NPI according to the public dataset.
What area of care is associated with CODY ENRIETTI (PT, DPT)?
CODY ENRIETTI (PT, DPT)'s record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with CODY ENRIETTI (PT, DPT)?
Directory geography for CODY ENRIETTI (PT, DPT) centers on Louisville, Kentucky.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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