Gary E. Bodenhausen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MDR6442 Issued in MO

Practice address

104 No. 7 Highway
Ste B
Blue Springs, MO 64014

Phone

(816) 229-8880

Fax

(816) 229-4363

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1376536458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 NO. 7 HIGHWAY",
            "address_2": "STE B",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "64014",
            "telephone_number": "816-229-8880",
            "fax_number": "816-229-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 NO. 7 HIGHWAY",
            "address_2": "STE B",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "64014",
            "telephone_number": "816-229-8880",
            "fax_number": "816-229-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENHAUSEN",
        "first_name": "GARY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "MDR6442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "06616078",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1023793",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue Springs Internal Medicine
• Blue Springs Psychological Services LLC
• Blue Springs R-IV School District
• Blue Springs Wellness & Rehabilitation LLC
• Bluesprings Group Inc
• Ben Boecklen
• Nathan Blair Boles, D.D.S.
• Samuel J Boone, OTR
• Renae Sue Borden, O.D.
• Angela Boston, M.D.

• Family Medicine Physician in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.