Jon F Bode, MD
Individual provider Active NPI Family Medicine Physician · Brenham, TX
NPI 1124090725 · NPPES record last updated Feb 15, 2013
Key facts
- NPI
- 1124090725
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- J6342 (TX)
- Practice address
- 601 Medical Parkway
Suite D
Brenham, TX 77833-5430 - Phone
- (979) 836-2822
- Fax
- (979) 836-1943
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Texas Southwestern Medical School at Dallas, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brenham Family Practice and Obstetrics PA.
Practice addresses (Care Compare)
601 Medical Pkwy
Suite D
Brenham, TX 77833-5430
Phone (979) 836-2822
Hospital & facility affiliations
- Accentcare Home Health of College Station
- Baylor Scott & White Hospital Brenham
- Baylor Scott & White Medical Center- College Stati
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Brenham Family Practice and Obstetrics PA. |
Rural health clinic | Contracted Managing Employee 5% Or Greater Direct Ownership Interest (28%) |
Dec 17, 2004 Mar 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100429000517 | TX | Practitioner - Family Practice |
9537106901 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brenham Family Practice and Obstetrics PA | Current |
Accepting new patients | |
| Brenham Family Practice and Obstetrics PA | Family Medicine | Current |
Accepting new patients |
| Scott & White Hospital Brenham | Past | Accepting new patients |
Locations
605 Medical Ct
Ste 203
Brenham, TX 77833
Phone (979) 353-5556
601 Medical Pkwy
Ste D
Brenham, TX 77833
Phone (979) 251-7273
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BHJCDD
- https://fhir4.healow.com/fhir/r4/BHJCDD/Endpoint/BHJCDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | J6342 | TX | Yes |
Addresses
Primary practice location
601 Medical Parkway
Suite D
Brenham, TX 77833-5430
Mailing address
601 Medical Pkwy
Suite D
Brenham, TX 77833-5429
Phone (979) 836-2822
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8657B9 | Other | TX | MEDICARE RENDERING |
| 157272901 | Medicaid | TX |
Other providers in Brenham, TX
- Robin Elizabeth Blankenburg
- Blinn College
- Bluebonnet Haven, LLC
- Bluebonnet Pediatric Dentistry PLLC
- Sandra Kay Blum
- Rachel Lynn Boer
- Matthew Howard Boutte
- Brandon Guillory OD
- Brazos Valley Apex Pain Specialists PLLC
- Brazos Valley Cancer Clinics, PLLC
All providers in Brenham, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.