Active NPI
Scott Bodendorfer, RPH
- Pharmacist
- Gainesville, FL
National Provider Identifier
1235416363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS41014
- Practice address
- 2415 SW 75TH Street
Gainesville, FL 32607 - Phone
- (352) 333-9704
- Fax
- (352) 333-9938
- NPI assigned
- Nov 3, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS41014 | FL | Primary |
Addresses
Primary practice location
2415 SW 75TH Street
Gainesville, FL 32607
Mailing address
4715 SW 91St Dr Unit 304
Gainesville, FL 32608-8116
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS41014 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1320278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1235416363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4715 SW 91ST DR UNIT 304",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326088116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 SW 75TH STREET",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "32607",
"telephone_number": "352-333-9704",
"fax_number": "352-333-9938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODENDORFER",
"first_name": "SCOTT",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-03",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS41014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.