Individual provider Active NPI

Robert Michael Bodine, D.C

  • Chiropractor
  • Oviedo, FL
National Provider Identifier
1194964973
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9685 Issued in FL
Practice address
57 Alafaya Woods Blvd
Oviedo, FL 32765-6234
Phone
(407) 977-3434
Fax
(407) 977-3433
NPI assigned
Feb 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9685 FL Primary

Addresses

Primary practice location

57 Alafaya Woods Blvd
Oviedo, FL 32765-6234

Mailing address

57 Alafaya Woods Blvd
Oviedo, FL 32765-6234
Phone (407) 977-3434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151103001269 FL Practitioner - Chiropractic 7618287699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wise Chiropractic PAGroup PAC ID 1052579174, 2 clinicians

Practice addresses (Care Compare)

18130 US Hwy 441
Mount Dora, FL 32757-6720
Phone (352) 729-5105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Chiropractic PA Chiropractor CurrentSince Jul 22, 2015 Accepting new patients
Elite Chiropractic & Sports Rehab LLC Chiropractor Past Accepting new patients
Neil a Patterson, MD, PA Past Accepting new patients
Maxlife Health and Wellness Center Chiropractor Past Accepting new patients

Locations

17941 US Highway 441
Mount Dora, FL 32757
Phone (352) 516-6820

18130 US Highway 441
Mount Dora, FL 32757
Phone (352) 729-5105

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1194964973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 ALAFAYA WOODS BLVD",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656234",
            "telephone_number": "407-977-3434",
            "fax_number": "407-977-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 ALAFAYA WOODS BLVD",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656234",
            "telephone_number": "407-977-3434",
            "fax_number": "407-977-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODINE",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.