Patrice D Boddie, M.D.
Individual provider Active NPI Internal Medicine Physician · Milledgeville, GA
NPI 1376530774 · NPPES record last updated Oct 13, 2010
Key facts
- NPI
- 1376530774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 027966 (GA)
- Practice address
- 240 N Wayne St
Milledgeville, GA 31061-3438 - Phone
- (478) 452-6999
- Fax
- (478) 452-7222
- NPI assigned
- Sep 30, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 4
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Meharry Medical College School of Medicine, 1985
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Medical Office Force
Practice addresses (Care Compare)
2005 Prince Ave
Athens, GA 30606-6032
Phone (706) 208-9700
240 N Wayne St
Milledgeville, GA 31061-3438
Phone (478) 452-6999
Hospital & facility affiliations
- Enhabit Home Health
- Navicent Health Baldwin
- Coliseum Medical Centers, LLC, Dba
- Atrium Health Navicent the Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Atrium Health Navicent Baldwin |
Hospital | Corporate Director | Sep 1, 2020 |
| Atrium Health Navicent Baldwin Skilled Nursing Unit |
Skilled nursing facility | Managing Control - Governing Body Trustee of the SNF |
Sep 1, 2020 Sep 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110920000838 | GA | Practitioner - Internal Medicine |
3971774118 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patrice D Boddie | Internal Medicine | Current |
Accepting new patients |
| Medical Office Force | Internal Medicine | Current |
Accepting new patients |
Locations
2005 Prince Ave
Athens, GA 30606
Phone (706) 296-8632
240 N Wayne St
Milledgeville, GA 31061
Phone (478) 452-6999
1001 N Clark St
Milledgeville, GA 31061
Phone (478) 452-6999
Interoperability endpoints
- patrice.boddie@oconeeregional.gadirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 027966 | GA | Yes |
Addresses
Primary practice location
240 N Wayne St
Milledgeville, GA 31061-3438
Mailing address
PO Box 1219
Milledgeville, GA 31059-1219
Phone (478) 452-6999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00316852B | Medicaid | GA | |
| 00316852A | Medicaid | GA | |
| 581759458 | Other | GA | TAX PAYER ID |
| 52238029 | Other | GA | BLUE CROSS/BLUE SHIELD |
Other providers in Milledgeville, GA
- Kandace Danielle Bivens
- Jaimie Lynn Blackwell
- Madilyn Harrington Blizzard
- Parker Rhett Blizzard
- Lisha Bly
- Norman Bostic
- Jacquelyn Nicole Bove
- Mary Dawn Bowen
- Christopher Bowers
- Ronald Jack Boyd
All providers in Milledgeville, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.