Active NPI
Anna S Bodnar, MEDICAL DOCTOR
- Pediatrics Physician
- Salt Lake City, UT
National Provider Identifier
1164573689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 152783-1205
- Practice address
- 44 N Medical Dr
Salt Lake City, UT 84113-1105 - Phone
- (801) 842-3672
- Fax
- (801) 584-8242
- NPI assigned
- Jan 12, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 152783-1205 | UT | Primary |
Addresses
Primary practice location
44 N Medical Dr
Salt Lake City, UT 84113-1105
Mailing address
6126 Oak Canyon Dr
Salt Lake City, UT 84121-6344
Phone (801) 584-8252
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 |
|---|---|---|---|
| 152783-1205 | UT | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164573689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6126 OAK CANYON DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841216344",
"telephone_number": "801-584-8252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 N MEDICAL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131105",
"telephone_number": "801-842-3672",
"fax_number": "801-584-8242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODNAR",
"first_name": "ANNA",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MEDICAL DOCTOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "152783-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.