Active NPI
Gregory N Bodily, O.D.
- Optometrist
- Boise, ID
National Provider Identifier
1013008614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ODP1013
- Practice address
- 610 Americana Blvd
Boise, ID 83702-6731 - Phone
- (208) 344-2020
- Fax
- (208) 344-2371
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODP1013 | ID | Primary |
Addresses
Primary practice location
610 Americana Blvd
Boise, ID 83702-6731
Mailing address
610 Americana Blvd
Boise, ID 83702-6731
Phone (208) 344-2020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
610 Americana Blvd
Boise, ID 83702-6731
Phone (208) 344-2020
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODP1013 | ID | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision One Inc | Optometrist | Current | Accepting new patients |
| Vision One McCall Inc | Optometrist | Past | Accepting new patients |
Locations
610 S Americana Blvd
Boise, ID 83702
Phone (208) 344-2020
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013008614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 AMERICANA BLVD",
"city": "BOISE",
"state": "ID",
"postal_code": "837026731",
"telephone_number": "208-344-2020",
"fax_number": "208-344-2371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 AMERICANA BLVD",
"city": "BOISE",
"state": "ID",
"postal_code": "837026731",
"telephone_number": "208-344-2020",
"fax_number": "208-344-2371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODILY",
"first_name": "GREGORY",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "ODP1013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.