Individual provider Active NPI

Richard Allen Boody, EMT IV

  • Basic Emergency Medical Technician
  • Heiskell, TN
National Provider Identifier
1073749446
Registry record updated May 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
0024131 Issued in TN
Practice address
709 Brushy Valley Rd
Heiskell, TN 37754-2809
Phone
(865) 457-5910
NPI assigned
May 30, 2009
Last updated
May 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 0024131 TN Primary

Addresses

Primary practice location

709 Brushy Valley Rd
Heiskell, TN 37754-2809

Mailing address

709 Brushy Valley Rd
Heiskell, TN 37754-2809
Phone (865) 457-5910

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
Emergency Medical Technician

State licenses

LicenseStateTypeSpecialty
0024131TNMDBasic Emergency Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1243641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243641600000",
    "number": "1073749446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 BRUSHY VALLEY RD",
            "city": "HEISKELL",
            "state": "TN",
            "postal_code": "377542809",
            "telephone_number": "865-457-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 BRUSHY VALLEY RD",
            "city": "HEISKELL",
            "state": "TN",
            "postal_code": "377542809",
            "telephone_number": "865-457-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOODY",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "EMT IV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-30",
        "last_updated": "2009-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "TN",
            "license": "0024131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heiskell, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2009; 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.