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

Cody Wayne Lawson, ATC

Individual provider Athletic Trainer · NPI 1477168565

Cody Wayne Lawson, ATC is a Physician Assistant in Minneapolis, Minnesota. Qualified in 2022, 4 years ago. Practices with Roanoke Valley Healthcare Partners LLC, a 56-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2020
Specialties on file
2
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

2211 Riverside Ave
Minneapolis, MN 55454-1350
Phone: (612) 330-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1477168565
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorNo
NPI enumeratedSeptember 15, 2020
Last updated in NPPESDecember 15, 2025
Certification dateDecember 15, 2025
Mailing address115 2nd Ave S Apt 701, Minneapolis, MN 55401-2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Roanoke Valley Healthcare Partners Llc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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