Active NPI
Sarah Erwin Bodnar, PT
- Physical Therapist
- Baltimore, MD
National Provider Identifier
1235189416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14433
- Practice address
- 515 Fairmount Ave
Suite 530
Baltimore, MD 21286-5466 - Phone
- (410) 494-1343
- Fax
- (410) 494-1386
- NPI assigned
- May 11, 2006
- Last updated
- Jun 13, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14433 | MD | Primary |
Addresses
Primary practice location
515 Fairmount Ave
Suite 530
Baltimore, MD 21286-5466
Mailing address
515 Fairmount Ave
Credentialing Department
Towson, MD 21286-5466
Phone (410) 494-1324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007063880 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14433 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifebridge Investments, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba LifeBridge Community Practices, LLC d/b/a Clinical Associates ASC
- Endoscopy Clinic/Center
- Towson, MD
- NPI 1861689382
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213315200000",
"number": "1235189416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 FAIRMOUNT AVE",
"address_2": "CREDENTIALING DEPARTMENT",
"city": "TOWSON",
"state": "MD",
"postal_code": "212865466",
"telephone_number": "410-494-1324",
"fax_number": "410-494-1361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 FAIRMOUNT AVE",
"address_2": "SUITE 530",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212865466",
"telephone_number": "410-494-1343",
"fax_number": "410-494-1386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODNAR",
"first_name": "SARAH",
"middle_name": "ERWIN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2008-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "14433",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007063880",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.