Patrice D Boddie

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

027966 Issued in GA

Legal business name

PATRICE D BODDIE

Practice address

240 N Wayne St
Milledgeville, GA 31061-3438

Phone

(478) 452-6999

Fax

(478) 452-7222

NPI assigned

Sep 18, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Patrice Boddie, M.D.NPI 1376530774

Title

Physician/Owner

Phone

(478) 452-6999

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patrice D Boddie, M.D.

  • Internal Medicine Physician
  • Milledgeville, GA
  • NPI 1376530774
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1194151498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N WAYNE ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310613438",
            "telephone_number": "478-452-6999",
            "fax_number": "478-452-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N WAYNE ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310613438",
            "telephone_number": "478-452-6999",
            "fax_number": "478-452-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICE D BODDIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-18",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "BODDIE",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "478-452-6999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "027966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "27966",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pboddie@bellsouth.net",
            "affiliation": "N",
            "address_1": "240 N Wayne St",
            "city": "Milledgeville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310613438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Phyllis M. Parks-Veal, PHARMD, RPH
• Breanna Rae Parrett, M.ED. CF-SLP
• Ricky C. Partin, CRNA
• Sandipkumar Patel, PHARMD
• Pathmedic
• Daniel Patrick, DC
• Peach State Nursing Agency
• Shakeitha Peeler
• John Penuel, M.D.
• Personal Foot & Ankle Specialist,PC

• Internal Medicine Physician in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.