Jody Lynn Boyer, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103280 Issued in MN

Practice address

1451 Highway 2
Two Harbors, MN 55616-4049

Phone

(218) 834-2586

Fax

(218) 834-2587

NPI assigned

Jun 17, 2010

Last updated

Jun 17, 2010By 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

Other names 1

• Jody Lynn Patullo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Bodies in Balance of Two Harbors, Inc.

  dba Bodies in Balance Inc.

  • Physical Therapist
  • Two Harbors, MN
  • NPI 1700082484
  NPD (past)

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1396066973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 HIGHWAY 2",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556164049",
            "telephone_number": "218-834-2586",
            "fax_number": "218-834-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 HIGHWAY 2",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556164049",
            "telephone_number": "218-834-2586",
            "fax_number": "218-834-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYER",
        "first_name": "JODY",
        "middle_name": "LYNN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODY",
            "last_name": "PATULLO",
            "middle_name": "LYNN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason Olai Berg, DDS
• Jacob Thomas Blong, DPT
• Blustin Optical Center Dba Derin J Van Loon, O.D.
• Bodies in Balance of Two Harbors, Inc. (Bodies in Balance Inc.)
• Nicole Bogenreif, PT, DPT
• Brightwater Health Dba Human Development Center
• Lisa D Bucklew, PHARMACY TECHNICIAN
• Jennifer Bushmaker
• Sara Byrns, M.A. CCC-SLP
• Daniel Cahill

• Occupational Therapist in Two Harbors, MN
• Providers in Two Harbors, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.