Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bosco Cody Theodore, DO

Individual provider Psychiatry Physician · NPI 1306422811

Bosco Cody Theodore, DO is a Psychiatry in Salem, Virginia. Graduated from Touro Un Col of Osteopathic Medicine, Henderson in 2021, 5 years ago. Practices with Lewis Gale Physicians LLC, a 194-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
5
Trained at
Touro Un Col of Osteopathic Medicine, Henderson
Licensed in
VA
In the registry since
2021
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1900 Electric Rd
Salem, VA 24153-7494
Phone: (540) 776-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 0102207976 (VA)

Record details

NPI number1306422811
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 23, 2021
Last updated in NPPESJune 19, 2025
Certification dateJune 19, 2025
Mailing address1900 Electric Rd, Salem, VA 24153-7494

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolTOURO UN COL OF OSTEOPATHIC MEDICINE, HENDERSON
Graduated 2021 (5 years in practice)
Group practice Lewis Gale Physicians Llc — 194 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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