Individual provider Active NPI

Jamie Hamblin Bodie, PA

  • Physician Assistant
  • Mobile, AL
National Provider Identifier
1053741462
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.2583 Issued in AL
Practice address
2451 University Hospital Dr
Mobile, AL 36617-2300
Phone
(251) 471-7000
Fax
(251) 471-7096
NPI assigned
Nov 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD003799 GA
Medical Physician Assistant 363AM0700X 10293 GA
Physician Assistant 363A00000X PA.2583 AL Primary

Addresses

Primary practice location

2451 University Hospital Dr
Mobile, AL 36617-2300

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (866) 401-3057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260603002342 GA Practitioner - Physician Assistant 1052534559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

341 Ponce de Leon Neave
Atlanta, GA 30308-2012
Phone (404) 616-2440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.2583ALMDPhysician Assistant
10293GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation Past Accepting new patients
Gomed, LLC PastSince Feb 1, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22872/brand/2/csg/1/fhir/r4

Organizations & group practices 3

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": "1384992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1053741462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "866-401-3057",
            "fax_number": "318-868-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300",
            "telephone_number": "251-471-7000",
            "fax_number": "251-471-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODIE",
        "first_name": "JAMIE",
        "middle_name": "HAMBLIN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-21",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD003799",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "10293",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.2583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.