Jessica Kay Bodager

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

PT40535 Issued in FL

Practice address

13000 Bruce B Downs Blvd
Tampa, FL 33612-4745

Phone

(813) 972-2000

NPI assigned

Aug 17, 2023

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1194508648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9309 PERSIMMON BROOK TRL APT 6-215",
            "city": "THONOTOSASSA",
            "state": "FL",
            "postal_code": "335923898",
            "telephone_number": "330-465-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124745",
            "telephone_number": "813-972-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODAGER",
        "first_name": "JESSICA",
        "middle_name": "KAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "PT40535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Edward Boccio, PHD
• Erica Boccumini
• Covena Charles Bocicot, APRN
• Philip Bockemeier
• Heather A Bockhold, APN
• Barry Bodanza, DC
• Jennifer Lynne Bodanza, L.M.T
• Christina Bode, DPT
• Garrett Slade Bode, D.C.
• Hannah Elizabeth Bodenhorn, LMHC

• Student in an Organized Health Care Education/Training Program in Tampa, FL
• Providers in Tampa, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.