NPIMap

Individual provider Active NPI

Jon F Bode, MD

  • Family Medicine Physician
  • Brenham, TX
National Provider Identifier
1124090725
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J6342 Issued in 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
Last updated
Feb 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J6342 TX Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100429000517 TX Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 9537106901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
University of Texas Southwestern Medical School at Dallas, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

601 Medical Pkwy
Suite D
Brenham, TX 77833-5430
Phone (979) 836-2822

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J6342TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brenham Family Practice and Obstetrics PA CurrentSince Jul 1, 2002 Accepting new patients
Brenham Family Practice and Obstetrics PA Family Medicine CurrentSince Jul 1, 2002 Accepting new patients
Scott & White Hospital Brenham Past Accepting new patients

Locations

601 Medical Pkwy
Ste D
Brenham, TX 77833
Phone (979) 251-7273

605 Medical Ct
Ste 203
Brenham, TX 77833
Phone (979) 353-5556

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHJCDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHJCDD/Endpoint/BHJCDD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brenham Family Practice and Obstetrics PA.Brenham, TX, CCN 673945 Rural health clinic Contracted Managing Employee
5% Or Greater Direct Ownership Interest (28%)		 Dec 17, 2004
Mar 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1124090725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEDICAL PKWY",
            "address_2": "SUITE D",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778335429",
            "telephone_number": "979-836-2822",
            "fax_number": "979-836-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MEDICAL PARKWAY",
            "address_2": "SUITE D",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778335430",
            "telephone_number": "979-836-2822",
            "fax_number": "979-836-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODE",
        "first_name": "JON",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

Verify at the official NPI Registry.