Michelle Bodenhamer, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2609 Issued in ID

Practice address

50 Ski Hill Rd
Driggs, ID 83422-0129

Phone

(208) 354-3128

NPI assigned

Oct 27, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• High Peaks Physical Therapy P a

  • Physical Therapist
  • Driggs, ID
  • NPI 1356412837
  NPD (past)

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1346576303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834220129",
            "telephone_number": "253-273-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 SKI HILL RD",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834220129",
            "telephone_number": "208-354-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENHAMER",
        "first_name": "MICHELLE",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT2609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1378483",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karlin L Bilcher, LPC, M. DIV
• Alexis Blaser, MS, RDN, LD
• Michael P Bleffert, PT
• Blue Zone Healthcare LLC
• Brent Blue, MD
• Liesje Chantal Bouwman, LMSW
• Halina Boyd
• Brent Blue MD
• Jennifer Lynn Brinson, LCSW
• Jessica Brodie, M.S., CCC-SLP

• Physical Therapist in Driggs, ID
• Providers in Driggs, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.