Brent Mitchell Bodily, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD-22451 Issued in HI

Practice address

18511 Highlander Medics St
Fort Bliss, TX 79906-5327

Phone

(801) 834-7551

NPI assigned

Apr 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1265061055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE ROAD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER",
            "city": "TAMC",
            "state": "HI",
            "postal_code": "968595001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18511 HIGHLANDER MEDICS ST",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799065327",
            "telephone_number": "801-834-7551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Road",
            "address_2": "Tripler Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "TAMC",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-2474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODILY",
        "first_name": "BRENT",
        "middle_name": "MITCHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "HI",
            "license": "MD-22451",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Qiaoqiao Bi
• Marquis Bias
• Courtney Tage Bigham
• Amanda Michelle Bischoff, FNP
• Jennifer L Bishop, DC
• Carli Bogolub
• Andrew Bohn, MD
• Joshua Charles Boring, MD
• Alejandro Borrego, MD
• John William Brabender, DO

• Obstetrics & Gynecology Physician in Fort Bliss, TX
• Providers in Fort Bliss, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.