Provider Demographics
NPI:1235352022
Name:BODYWORX PHYSICAL THERAPY, P.A.
Entity Type:Organization
Organization Name:BODYWORX PHYSICAL THERAPY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:316-558-8808
Mailing Address - Street 1:430 N WOODLAWN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-4334
Mailing Address - Country:US
Mailing Address - Phone:316-558-8808
Mailing Address - Fax:316-558-8818
Practice Address - Street 1:430 N WOODLAWN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4334
Practice Address - Country:US
Practice Address - Phone:316-558-8808
Practice Address - Fax:316-558-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS133V00000X, 225100000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS115682Medicare ID - Type Unspecified