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

Individual provider Athletic Trainer · NPI 1518404557

Cody Derby, LAT, ATC is an Athletic Trainer in Lakeland, Florida. Works from 2 locations. Licensed in Florida and Missouri.

Licensed in
FL, MO
In the registry since
2017
Specialties on file
2
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

2301 Lakeland Hills Blvd
Lakeland, FL 33805-2909
Phone: (863) 413-4116
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4525 Downs Dr, Saint Joseph, MO 64507-2246 — (816) 271-4597

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AL5128 (FL)
Athletic Trainer Taxonomy 2255A2300X · Licence 2017002382 (MO)

Record details

NPI number1518404557
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT , ATC
Sole proprietorNo
NPI enumeratedJanuary 29, 2017
Last updated in NPPESJanuary 27, 2021
Certification dateJanuary 27, 2021

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