Individual provider Active NPI

Kodi M Bone, PA-C

  • Physician Assistant
  • Ludington, MI
National Provider Identifier
1184886012
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7 Atkinson Dr Ste 115
Ludington, MI 49431-1953
Phone
(231) 845-2270
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7 Atkinson Dr Ste 115
Ludington, MI 49431-1953

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20190124002419 MI Practitioner - Physician Assistant 1456698778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 Michigan St NE
Suite 3100
Grand Rapids, MI 49503-2563
Phone (616) 954-9800

6425 S Harvey St
Norton Shores, MI 49444-9739
Phone (231) 737-3469

710 Kenmoor Ave SE
Suite 200
Grand Rapids, MI 49546-2379
Phone (616) 389-1800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer & Hematology Centers of Western Mi, P.C. CurrentSince Sep 12, 2022 Accepting new patients
Cancer & Hematology Centers of Western Mi, P.C. Past Accepting new patients
Spectrum Health Hospitals Past Accepting new patients

Locations

12460 Riley St
Holland, MI 49424
Phone (616) 399-1308

6425 Harvey St
Norton Shores, MI 49444
Phone (231) 737-3469

Organizations & group practices 4

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 5

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1184886012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790",
            "fax_number": "907-580-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ATKINSON DR STE 115",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311953",
            "telephone_number": "231-845-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONE",
        "first_name": "KODI",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

Verify at the official NPI Registry.