William Bodine, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10001661A Issued in IN

Practice address

1701 S Creasy LN
Lafayette, IN 47905-4972

Phone

(765) 502-4000

NPI assigned

Jun 25, 2014

Sex

Male

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

Enrolled in IN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Indiana Emergency Solutions LLC

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1255691424
  NPD (past)

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1114332459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "STE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437241",
            "telephone_number": "317-865-8988",
            "fax_number": "317-859-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S CREASY LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054972",
            "telephone_number": "765-502-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODINE",
        "first_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001661A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly Lyn Blocher, CSFA
• Elyse Blue
• James Lee Blumling, MD
• Nicholas J. Bobis, MS, OTR/L, ATC
• Matvey V Bobylev, MD
• Noelle K Boehle, CST
• Michael D. Bohlin, M.D.
• Islam Abbas Bolad, MD
• Emma Elizabeth Boles
• Riley Bolin, BCBA

• Medical Physician Assistant in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.