MR. CODY THOMAS KENISON (D.P.T.) – Physical Therapist, NPI 1215131529

MR. CODY THOMAS KENISON (D.P.T.) is a healthcare provider. based in Mill creek, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials D.P.T.. They hold a License No. PT60099101 (WA). The NPI Number for MR. CODY THOMAS KENISON (D.P.T.) is 1215131529

Main info

Male
19 Years Of Experience
Accepts Medicare Assignment
Name
MR. CODY THOMAS KENISON (D.P.T.)
NPI
1215131529
Phone
(425) 357-9380
Address
4220 132ND ST SE
Enumeration Date
12 June 2007
Last Update Date
1 May 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5093850900
Graduation Year
2007 (19 years ago)
PAC ID
2163513805
Group Practice PAC ID
8325937642
Professional Enrollment ID
I20090924000349
Address ID
WA992056512SP822XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

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Provider Addresses for MR. CODY THOMAS KENISON (D.P.T.)

  • 4220, 132nd Street Southeast, Mill Creek, Snohomish County, Washington, 98012, United States

    SUITE101

    MILL CREEK, WA 980128999

    Phone: (425) 357-9380

    Fax: (425) 357-9382

    Type: Mailing

  • 201, West North River Drive, Riverside, Spokane, Spokane County, Washington, 99201, United States

    SUITE 510

    SPOKANE, WA 992012284

    Phone: (509) 323-0066

    Fax: (509) 323-0067

    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: 2009-09-24

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
I20090924000349IPhysical Therapist In Private PracticeWATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes67649$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes41747$0
97140Therapy procedure using manual technique, each 15 minutes37945$0
97530Therapy procedure using functional activities7513$0
97161Evaluation for physical therapy, typically 20 minutes2726$0
View full utilization report →

Insurance plans in this area (ZIP 98012)

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Provider's Procedures

MR. CODY THOMAS KENISON (D.P.T.) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYWA97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes14218

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: 8325937642View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Occupational Therapist In Private PracticeAZ
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeOR
-OR
Physical Therapist In Private PracticeWA
-WA

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Frequently asked questions

Is there an official ID for MR. CODY THOMAS KENISON (D.P.T.) in U.S. healthcare records?
The official identifier for MR. CODY THOMAS KENISON (D.P.T.) is NPI 1215131529.
Active or inactive — what applies to MR. CODY THOMAS KENISON (D.P.T.)?
You should see MR. CODY THOMAS KENISON (D.P.T.) as active in CMS-hosted NPPES data.
What expertise is attributed to MR. CODY THOMAS KENISON (D.P.T.)?
MR. CODY THOMAS KENISON (D.P.T.)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MR. CODY THOMAS KENISON (D.P.T.)?
Travel planning: use Mill Creek, Washington as the reference point for MR. CODY THOMAS KENISON (D.P.T.), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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