Boden Fitness System LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

0101256096 Issued in VA

Legal business name

BODEN FITNESS SYSTEM LLC

Practice address

125 Prosperity Dr
Suite 500B
Winchester, VA 22602-5385

Phone

(540) 508-0779

Fax

(540) 508-0841

NPI assigned

Dec 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jordan Le Tran, M.D.

Title

Medical Director

Phone

(540) 508-0779

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1083157499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PROSPERITY DR",
            "address_2": "SUITE 500B",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226025385",
            "telephone_number": "540-508-0779",
            "fax_number": "540-508-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PROSPERITY DR",
            "address_2": "SUITE 500B",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226025385",
            "telephone_number": "540-508-0779",
            "fax_number": "540-508-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODEN FITNESS SYSTEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-02",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "LE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "540-508-0779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "VA",
            "license": "0101256096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "VV748A",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue Ridge Womens Care PC
• Richard Blum
• Catherine L Boatright, OTR/L
• Ramona Jeanne Bock, MSN, FNP-C
• Boden Fitness Durable Medical Equipment
• Boden Health National Gout Centers, LLC
• Boden Health System LLC
• Boden Health Urgent Care
• Body Elite Physical Therapy Inc
• Maria A Bogaert, M.D.

• Preferred Provider Organization in Winchester, VA
• Providers in Winchester, VA by specialty
• Preferred Provider Organization in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.