NPIMap

Organization Active NPI

Bodle Chiropractic, Inc

  • Chiropractor
  • Des Moines, WA
National Provider Identifier
1043484843
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002092 Issued in WA
Legal business name
BODLE CHIROPRACTIC, INC
Practice address
22312 Marine View Dr S
Des Moines, WA 98198-6832
Phone
(206) 824-8464
NPI assigned
Apr 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Authorized official

Name
Dr. Michael J. Bodle, D.CNPI 1356315881
Title
Chiropractor
Phone
(206) 824-8464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00002092 WA Primary

Addresses

Primary practice location

22312 Marine View Dr S
Des Moines, WA 98198-6832

Mailing address

22312 Marine View Dr S
Des Moines, WA 98198-6832
Phone (206) 824-8464

Other names 1

  • Bodle Chiropractic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080519000173 WA Part B Supplier - Clinic/Group Practice 3870662745 Receives reassigned benefits from 1 practitioner
Practice locations: Des Moines, WA

National Provider Directory

National Provider Directory
Tax ID family
Bodle Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

22312 Marine View Dr S
Des Moines, WA 98198
Phone (206) 824-8464

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1043484843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22312 MARINE VIEW DR S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986832",
            "telephone_number": "206-824-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22312 MARINE VIEW DR S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986832",
            "telephone_number": "206-824-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODLE CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "BODLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "206-824-8464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bodle Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.