Joan Carol Bodnar, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

772019 Issued in WI

Practice address

2301 N Lake Dr
Milwaukee, WI 53211-4508

Phone

(414) 298-6730

NPI assigned

Oct 19, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1093090201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3859 S AUSTIN ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532073912",
            "telephone_number": "414-481-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N LAKE DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114508",
            "telephone_number": "414-298-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "JOAN",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "772019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Bodenhausen, MD
• Joshua Alan Bodie, MD
• Bodies in Motion Physical Therapy and Wellness Inc.
• Savannah Bodjanac, MS/CCC-SLP
• Kevin Andrew Bodker, DO
• Myron O Bodnar, MD
• Heaven Body
• Beau Boedecker, PA-C
• Alecia Boeder, PA-C
• Sarah Boeding, PHD, MS, MED

• Physical Therapy Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.