CODY JORDAN HARRIS (PA-C) – Medical Physician Assistant, NPI 1306343512

CODY JORDAN HARRIS (PA-C) is a healthcare provider. based in Waldo, Ohio. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 50.005564RX (OH). The NPI Number for CODY JORDAN HARRIS (PA-C) is 1306343512

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
CODY JORDAN HARRIS (PA-C)
NPI
1306343512
Phone
(740) 225-3833
Address
5612 SAINT JAMES RD
Enumeration Date
12 April 2018
Last Update Date
26 March 2022

Doctor Profile

Medical School Name
TOLEDO MEDICAL COLLEGE
Secondary Phone
-
Graduation Year
2017 (9 years ago)
PAC ID
0941741003
Group Practice PAC ID
4880979061
Professional Enrollment ID
I20240917003354
Address ID
OH433026225Ma970XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

5,032 PHYSICIAN ASSISTANT in OH

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Provider Addresses for CODY JORDAN HARRIS (PA-C)

  • 5612, Saint James Road, Waldo Township, Marion County, Ohio, 43356, United States

    WALDO, OH 433569110

    Phone: (740) 225-3833

    Type: Mailing

  • 376 BENJAMIN ST

    DELAWARE, OH 430157523

    Phone:

    Type: Mailing

  • 970, Prospect Street, Fountain Square, Indianapolis, Marion, Indiana, 46203, United States

    MARION, OH 433026225

    Phone: (740) 382-9293

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 91 Open Payments records for all available years, with a total value of $1,631.

Total Amount is formed as General ($1,631) + Research ($0) + Ownership ($0) = $1,631.

Last reported payment date: 2024-12-22 • Largest payer in this snapshot: ABBVIE INC. ($424).

Total Amount

$1,631

General + Research + Ownership

Payments

91

Total payment records

General Amount

$1,631

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-09-17

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
I20240917003354IPhysician AssistantOHTBD

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 43356)

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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: 4880979061View full group profile
NameSpecialtyState
Internal MedicineOH

Reviews

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Frequently asked questions

Is CODY JORDAN HARRIS (PA-C) listed with a National Provider Identifier?
Yes — CODY JORDAN HARRIS (PA-C) has NPI 1306343512 on file in the registry.
Is there an active status for CODY JORDAN HARRIS (PA-C)?
For scheduling context, CODY JORDAN HARRIS (PA-C) is shown as active in the registry.
What clinical focus is listed for CODY JORDAN HARRIS (PA-C)?
At a glance, CODY JORDAN HARRIS (PA-C) is tied to Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for CODY JORDAN HARRIS (PA-C)?
Travel planning: use Waldo, Ohio as the reference point for CODY JORDAN HARRIS (PA-C), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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