Frederick Earl Bodenhamer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T02261 Issued in MO

Practice address

3238 West Truman Boulevard
Jefferson City, MO 65109-2936

Phone

(573) 635-2020

Fax

(573) 635-7840

NPI assigned

Feb 25, 2007

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 MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bodenhamer Eye Consultants, LLCGroup PAC ID 8820227812, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bodenhamer Eye Consultants, LLC

  • Corneal and Contact Management Optometrist
  • Jefferson City, MO
  • NPI 1679903330
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1134255243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3238 W TRUMAN BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095708",
            "telephone_number": "573-636-3882",
            "fax_number": "573-635-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3238 WEST TRUMAN BOULEVARD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092936",
            "telephone_number": "573-635-2020",
            "fax_number": "573-635-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENHAMER",
        "first_name": "FREDERICK",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-25",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Blochberger, MED, ATC, LAT
• Helen Bock
• Susan Bock
• Bodenhamer Eye Consultants, LLC
• Bret Allen Bodenhamer, O.D.
• Shaina Elizabeth Boehm
• Luke Boehmer, PHARMD
• Cali Inez Boessen
• David Leroy Bollinger, H.I.S
• Mary Clare Bollinger, H.I.S.

• Optometrist in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.