Dr Bodman Podiatry Associates Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

36001747 Issued in OH

Legal business name

DR BODMAN PODIATRY ASSOCIATES INC

Practice address

21245 Lorain Road
Suite 115
Fairview Park, OH 44126-2140

Phone

(440) 356-1989

Fax

(440) 356-5944

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Michael James Bodman, DPMNPI 1386615144

Title

Physician/President

Phone

(440) 356-1989

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH2 enrollments

Enrollment records 2

Locations

Practitioners 3

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

• Michael James Bodman, DPM

  • Primary Podiatric Medicine Podiatrist
  • Fairview Park, OH
  • NPI 1386615144
  Medicare reassignment Care Compare group NPD Authorized official
• Rachel Elizabeth Johnson, D.P.M.

  • Podiatrist
  • Fairview Park, OH
  • NPI 1437445640
  Medicare reassignment Care Compare group NPD
• Laurence John Lembach, DPM

  • Primary Podiatric Medicine Podiatrist
  • Lakewood, OH
  • NPI 1972565844
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1215008735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21245 LORAIN ROAD",
            "address_2": "SUITE 115",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262140",
            "telephone_number": "440-356-1989",
            "fax_number": "440-356-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21245 LORAIN ROAD",
            "address_2": "SUITE 115",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262140",
            "telephone_number": "440-356-1989",
            "fax_number": "440-356-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BODMAN PODIATRY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "BODMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "440-356-1989",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36001747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2250237",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.