Brent Bode, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10968 Issued in WI

Practice address

807 N Jefferson St
Milwaukee, WI 53202-8150

Phone

(414) 224-8219

Fax

(414) 224-8246

NPI assigned

Feb 13, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marquette UniversityGroup PAC ID 0648221028, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marquette University

  • Physical Therapist
  • Milwaukee, WI
  • NPI 1396020194
  Medicare reassignment Care Compare group NPD
• Marquette University

  • Audiologist
  • Milwaukee, WI
  • NPI 1629556592
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1003084005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 QUAIL CT",
            "address_2": "SUITE 200",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723790",
            "telephone_number": "262-695-3057",
            "fax_number": "262-695-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 N JEFFERSON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532028150",
            "telephone_number": "414-224-8219",
            "fax_number": "414-224-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODE",
        "first_name": "BRENT",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL NUMBERS APPLIED FOR",
            "identifier": "APPLIED FOR",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361161700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Bock, PHARMD
• Jonathon M Bock, M.D.
• Hindolo Nathaniel Bockarie, R.N.
• James A Bockeloh, DNP, APNP
• Seth Bodden, MD
• Brycen D. Bodell, M.D.
• Michael Bodenhausen, MD
• Joshua Alan Bodie, MD
• Bodies in Motion Physical Therapy and Wellness Inc.
• Savannah Bodjanac, MS/CCC-SLP

• Physical Therapist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.