Mary Hyacinth Bodenheimer, NURSE PRACTITIONER-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN1782662 Issued in FL

Practice address

212 S Florida St
Bushnell, FL 33513-6703

Phone

(352) 793-2441

Fax

(352) 793-3282

NPI assigned

Sep 11, 2018

Last updated

May 28, 2019By the provider in NPPES

Sex

Female

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 FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Primary Care Providers IncGroup PAC ID 1951566728, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Concierge Home Care Home health agency, Ocala, FL, CCN 687152
• Centerwell Home Health Home health agency, Ocala, FL, CCN 107512
• Village Home Care LLC Home health agency, Lady Lake, FL, CCN 108125
• Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
• Hospice of Marion County Inc Hospice, Ocala, FL, CCN 101518

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primary Care Providers Inc

  • Family Medicine Physician
  • Ocala, FL
  • NPI 1083989438
  Medicare reassignment Care Compare group NPD
• Lowell F. Clark MD PA

  • Internal Medicine Physician
  • Bushnell, FL
  • NPI 1629278882
  Medicare reassignment

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

• Centerwell Health Services (Certified), Inc.

  dba Centerwell Home Health

  • Home Health Agency
  • Ocala, FL
  • NPI 1841229515
  Care Compare affiliation Name & address match
• CHC of Ocala LLC

  dba Concierge Home Care

  • Home Health Agency
  • Ocala, FL
  • NPI 1285236968
  Care Compare affiliation
• Hospice of Marion County Inc

  • Community Based Hospice Care Agency
  • Ocala, FL
  • NPI 1235189440
  Care Compare affiliation
• Village Home Care, LLC

  • Home Health Agency
  • Ocala, FL
  • NPI 1841252210
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Boynton Beach, FL
  • NPI 1467507657
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Miami Lakes, FL
  • NPI 1528113792
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Melbourne, FL
  • NPI 1669548053
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Tallahassee, FL
  • NPI 1972555464
  Care Compare affiliation

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1154804615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S FLORIDA ST",
            "city": "BUSHNELL",
            "state": "FL",
            "postal_code": "335136703",
            "telephone_number": "352-793-2441",
            "fax_number": "352-793-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S FLORIDA ST",
            "city": "BUSHNELL",
            "state": "FL",
            "postal_code": "335136703",
            "telephone_number": "352-793-2441",
            "fax_number": "352-793-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENHEIMER",
        "first_name": "MARY",
        "middle_name": "HYACINTH",
        "credential": "NURSE PRACTITIONER-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN1782662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annalice LLC (Pegasus Rx Pharmacy)
• Shannon Lee Jett Berry, MA, CCC-SLP
• Kurt Neal Blackman, DNP, APRN
• Kattia Blanco, MD
• Blessed at Home LLC
• Ronnie-Jane Boekema, ARNP
• Allison Bootz, MS, LAT, ATC
• Eleanor A Bower, LCSW
• Angel L. Bruno, M.D.
• Bushnell Family and Cosmetic Dentistry PLLC

• Adult Health Nurse Practitioner in Bushnell, FL
• Providers in Bushnell, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.