NPIMap

Individual provider Active NPI

Bradley Joseph Bodle, D.C.

  • Neurology Chiropractor
  • Des Moines, WA
National Provider Identifier
1326444399
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
CH60513691 Issued in WA
Practice address
22312 Marine View Dr S
Des Moines, WA 98198-6832
Phone
(206) 824-8464
Fax
(206) 842-8470
NPI assigned
Nov 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X CH60513691 WA Primary

Addresses

Primary practice location

22312 Marine View Dr S
Des Moines, WA 98198-6832

Mailing address

22312 Marine View Dr S
Des Moines, WA 98198-6832
Phone (206) 824-8464

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

State licenses

LicenseStateTypeSpecialty
CH60513691WAMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bodle Chiropractic, Inc PastSince Oct 29, 2023 Accepting new patients
Bodle Chiropractic, Inc PastSince Apr 15, 2008 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": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1326444399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22312 MARINE VIEW DR S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986832",
            "telephone_number": "206-824-8464",
            "fax_number": "206-842-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22312 MARINE VIEW DR S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986832",
            "telephone_number": "206-824-8464",
            "fax_number": "206-842-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODLE",
        "first_name": "BRADLEY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "WA",
            "license": "CH60513691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.