Stephanie Lynn Bodamer, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

71013603A Issued in IN

Practice address

1310 W Bloomfield Rd Ste C
Bloomington, IN 47403-2001

Phone

(812) 334-2772

NPI assigned

Feb 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1104524818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 W LEIGHTON LN",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474038949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W BLOOMFIELD RD STE C",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032001",
            "telephone_number": "812-334-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODAMER",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71013603B",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71013603A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bloomington Township Department of Fire and Emergency Services
• Bloomington Travelers LLC
• Christine Boardman, NP
• Anne Boch, PHD
• Theresa Ann Bock, APRN, BC, FNP
• Katherine A Boeck, LCSW
• Libby Lynn Boehner
• Maribel Berenice Boggess, NP
• Madison Boggs
• Deborah Boits, LCSW

• Primary Care Nurse Practitioner in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Primary Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.