Individual provider Active NPI

Amie S Bodin, PHARM D

  • Pharmacist
  • Lafayette, LA
National Provider Identifier
1073004040
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
018019 Issued in LA
Practice address
6770 Johnston St
Lafayette, LA 70503-6202
Phone
(337) 706-7706
Fax
(337) 706-7729
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 018019 LA Primary

Addresses

Primary practice location

6770 Johnston St
Lafayette, LA 70503-6202

Mailing address

200 Hundred Oaks Dr
Youngsville, LA 70592-5482
Phone (337) 654-8835

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
018019LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1073004040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HUNDRED OAKS DR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925482",
            "telephone_number": "337-654-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6770 JOHNSTON ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705036202",
            "telephone_number": "337-706-7706",
            "fax_number": "337-706-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODIN",
        "first_name": "AMIE",
        "middle_name": "S",
        "name_prefix": "Miss",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "018019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.