James E. Bodoh, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Elkhorn, WI
NPI 1043394604 · NPPES record last updated Sep 6, 2012
Key facts
- NPI
- 1043394604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 44932 (WI)
- Practice address
- W3985 County Road NN
Elkhorn, WI 53121-4337 - Phone
- (262) 741-2037
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44932 | WI | MD | Interventional Cardiology Physician |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Past | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 44932 | WI | Yes |
Addresses
Primary practice location
W3985 County Road NN
Elkhorn, WI 53121-4337
Mailing address
W3985 County Road NN
Elkhorn, WI 53121-4337
Phone (262) 741-2037
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43282000 | Medicaid | WI | |
| 27G29BO | Other | MN | BCBS MN FACILITY |
| 843042000 | Medicaid | MN | |
| 20-00293 | Other | MN | MEDICA |
| 64Q23BO | Other | MN | BCBS MN PRO FEE |
| NA9031006543 | Other | MN | PREFERRED ONE |
| HP10148 | Other | MN | HEALTHPARTNERS |
Other providers in Elkhorn, WI
- Cary E Berkowitz
- Harvinder Bhardwaj
- Elizabeth Ann Bilskey
- Chetney Marie Blaszczyk
- Katelyn Blatter
- Desiree Amber Bonngard
- Jaymie Ann Braden
- Christopher Bragagnolo
- Mary Brauer
- Kelly L Brazer
All providers in Elkhorn, WI · Certified Registered Nurse Anesthetist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.