Jessica Bodenhamer

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

6049 Shallowford Rd
Chattanooga, TN 37421-1688

Phone

(423) 266-6751

NPI assigned

Nov 30, 2018

Last updated

Apr 20, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Helen Ross McNabb Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Knoxville, TN
  • NPI 1659330686
  NPD (past)
• Mental Health Centers & Clinics of Tennessee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chattanooga, TN
  • NPI 1790811149
  NPD (past)

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1336619428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W SPRINGDALE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379175158",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6049 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211688",
            "telephone_number": "423-266-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENHAMER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele April Boaz, P.T.
• Nichole E Boaz, D.D.S.
• Valerie A Boaz, MD
• Kimberly Bobenhausen
• Ryan Bode, DO
• Bodies in Balance Physical Therapy, PLLC
• Matthew Bodine
• Melanie Joy/McCollum Bodine, RN/CNNP
• James Robert Bodkin, B.S.,D.C.
• Peter Eric Boehm Jr., MD

• Specialist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.