Active NPI
Brooke Bodnar
- Hearing Instrument Specialist
- Southern Pines, NC
National Provider Identifier
1053917062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 1618
- Practice address
- 160 Pinehurst Ave Ste G
Southern Pines, NC 28387-7078 - Phone
- (910) 246-0583
- NPI assigned
- Dec 7, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 1618 | NC | Primary |
Addresses
Primary practice location
160 Pinehurst Ave Ste G
Southern Pines, NC 28387-7078
Mailing address
1117 Capeharbor CT Apt 12
Fayetteville, NC 28314-2830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1053917062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1117 CAPEHARBOR CT APT 12",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283142830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 PINEHURST AVE STE G",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283877078",
"telephone_number": "910-246-0583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODNAR",
"first_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "NC",
"license": "1618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southern Pines, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.