Fakhra Ahmad-Bodla, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-113025 Issued in AL

Practice address

400 Sun Temple Dr
Madison, AL 35758-5924

Phone

(256) 774-5524

Fax

(256) 774-5523

NPI assigned

Mar 1, 2007

Last updated

Oct 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fakhra.ahmad-bodla.1@12216.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/12216/brand/1/csg/1/fhir/r4

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.

• Madison Primary Care LLC

  dba Madison Primary Care

  • Family Medicine Physician
  • Madison, AL
  • NPI 1881993210
  Medicare reassignment NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1285762344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 FOXHOUND DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357586881",
            "telephone_number": "626-644-7723",
            "fax_number": "256-774-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585924",
            "telephone_number": "256-774-5524",
            "fax_number": "256-774-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD-BODLA",
        "first_name": "FAKHRA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000013314",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "14489",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-113025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152756",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Advent Health LLC (Madison Integrative Medicine)
• Aesthetic and Reconstructive Dentistry, LLC (Madison Prosthodontics: Aesthetic and Reconstructive Dentistry, LLC)
• Affordable Dentures - Huntsville, P.C.
• Agilitas USA, Inc (Results Physiotherapy)
• Agilitas USA, Inc (Results Physiotherapy)
• Alabama Allergy & Asthma Care LLC
• Alabama Allergy & Asthma Care, LLC
• Alabama Allergy, Asthma, and Sinus Care
• Alabama Behavioral Health PC
• Alabama CVS Pharmacy LLC (CVS Pharmacy #17652)

• Family Nurse Practitioner in Madison, AL
• Providers in Madison, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2023; 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.