Active NPI
David Bodnarchuk
- Optician
- Naples, FL
National Provider Identifier
1124267612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO2644
- Practice address
- 7955 Airport Pulling Rd N
Suite 104
Naples, FL 34109-1794 - Phone
- (239) 593-7747
- NPI assigned
- Feb 6, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO2644 | FL | Primary |
Addresses
Primary practice location
7955 Airport Pulling Rd N
Suite 104
Naples, FL 34109-1794
Mailing address
6190 Spanish Oaks LN
Naples, FL 34119-8601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO2644 | Other | FL | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO2644 | FL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233878400000",
"number": "1124267612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6190 SPANISH OAKS LN",
"city": "NAPLES",
"state": "FL",
"postal_code": "341198601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7955 AIRPORT PULLING RD N",
"address_2": "SUITE 104",
"city": "NAPLES",
"state": "FL",
"postal_code": "341091794",
"telephone_number": "239-593-7747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODNARCHUK",
"first_name": "DAVID",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-06",
"last_updated": "2009-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO2644",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "DO2644",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.