MEDICARE: CODY CHARLES ASHY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	DR.0077034	CO
2	207X00000X	Orthopaedic Surgery Physician	LL85134	SC
3	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	DR.0077034	CO

General Provider Information

NPI Number	:	1285235705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CODY CHARLES ASHY MD

Provider Business Mailing Address
First Line	:	169 ASHLEY AVE RM 202
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8905
Country	:	US
Telephone Number	:	843-792-1792
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 ASHLEY AVE RM 202
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8905
Country	:	US
Telephone Number	:	843-792-1792
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2020
Last Update Date	:	06/02/2026

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