Mark N Bodily, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD16190 Issued in OR

Practice address

3333 Riverbend Dr
Springfield, OR 97477-8800

Phone

(541) 222-3154

NPI assigned

Jun 29, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mbodily@yourcarecommunity.org

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1033147129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7247",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974750011",
            "telephone_number": "541-686-9551",
            "fax_number": "541-687-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-222-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODILY",
        "first_name": "MARK",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD16190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050027246",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A007",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091751",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin R Bock, PHD
• Gustav Aiden Bock
• Kimberly A Bock, M.D.
• Brooke A Bodeen, N.D.
• Dawn M Bodell, DO
• Callay Quinn Boire-Shedd
• Maria Bolanos, D.O.
• Elizabeth Larkin Bolen, MSMFT
• Stacey O'Shea Bonomo, LPN
• Sarah M Boothe

• Anesthesiology Physician in Springfield, OR
• Providers in Springfield, OR by specialty
• Anesthesiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.