NPIMap

Individual provider Active NPI

Kyle Bodley, D.O.

  • Pediatrics Physician
  • Billings, MT
National Provider Identifier
1417110081
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
12740 Issued in MT
Practice address
3401 Avenue E
Billings, MT 59102-6561
Phone
(406) 238-6600
NPI assigned
Jul 3, 2008
Last updated
Jul 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 12740 MT Primary

Addresses

Primary practice location

3401 Avenue E
Billings, MT 59102-6561

Mailing address

3401 Avenue E
Billings, MT 59102-6561
Phone (406) 238-6600

Other identifiers 1

IdentifierTypeStateIssuer
4062386600OtherMTPHONE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
12740MTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Colorado Current Accepting new patients
SCL Health Montana Past Accepting new patients
The Childrens Clinic of Billings, PC Pediatrics Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
St. Vincent Healthcare Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kbodley41637@direct.childrenscolorado.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1417110081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 AVENUE E",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591026561",
            "telephone_number": "406-238-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 AVENUE E",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591026561",
            "telephone_number": "406-238-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODLEY",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "12740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHONE NUMBER",
            "identifier": "4062386600",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.